首页期刊导航|中华器官移植杂志
期刊信息/Journal information
中华器官移植杂志
中华器官移植杂志

陈实

月刊

0254-1785

j_organtx@vip.163.com

027-82806143

430014

湖北省武汉市江岸区胜利街155号

中华器官移植杂志/Journal Chinese Journal of Organ TransplantationCSCD北大核心CSTPCD
查看更多>>1980年10月创刊，中华医学会主办，中华医学会武汉分会承办。本刊反映了我国器官移植实验研究、临床研究的进展，以及我国器官移植及其相关学科的发展水平。本刊为“中国科技论文统计源期刊”、国家外科学以及生物科学核心期刊、《中国科学引文数据库》以及《中国学术期刊综合评价数据库》来源期刊，被《万方数据资源系统数字化期刊群》独家全文收录，被《美国化学文摘（CA）》收录，并加入WHO西太平洋地区医学索引。
正式出版
收录年代

    肾脏移植免疫监测临床诊疗指南

    中华医学会器官移植学分会中国医药生物技术协会移植技术分会陈刚
    6-18页
    查看更多>>摘要：预防肾移植排斥反应离不开免疫抑制剂，但免疫抑制过度相关的感染也会影响移植肾和移植受者的存活。主动监测肾移植受者的免疫状态有利于早期发现排斥反应风险或感染风险，有助于指导临床调整免疫抑制的强度。本指南围绕我国目前现有可行的免疫监测指标进行推荐和说明，以期有利于提高移植肾和移植受者的长期存活。 Immunosuppressive agents are essential for the prevention of renal allograft rejection, but infections associated with over immunosuppression can also affect the patient and graft survival. Regular monitoring of the recipient's immune status is conducive to early identifying the risky of rejection or infection, and can be helpful to guide clinical adjustment of immunosuppressive therapy. This guideline recommends and explains the currently available immune surveillance methods in order to ultimately improve the long-term survival of the kidney allografts and recipients.

    肾移植免疫监测排斥反应感染供者特异性抗体指南

      原文链接:
    • 万方数据

    器官移植开创者和艺术家罗伊·卡恩

    陈实
    131-135页
    查看更多>>摘要：罗伊·卡恩（Roy Calne）爵士是英国器官移植外科先驱，欧洲肝移植开拓者（图1）。在临床肾移植、心脏移植成功后的早期，人们一直认为肝移植不可能成功。但卡恩最不愿意别人说"这是不可能的"，在大西洋的两岸，他与美国匹兹堡大学的托马斯·斯塔兹（Thomas Starzl）教授一起，用不懈的努力与外界对于肝移植手术的质疑和批评抗争，极力设法让终末期肝病患者在接受肝移植后获得新生，直到20世纪80年代初期肝移植被临床所接受。同时，卡恩也是移植免疫抑制剂之父，他参与开发的硫唑嘌呤、环孢素A(cyclosporin A，CsA)等抗排斥药物使移植物得以长期存活。此外，在拥有精湛外科手术技术的同时，卡恩还是一位颇有成就的画家和雕塑家。
      原文链接:
    • 万方数据

    中国遗体捐献肾脏灌注、保存及修复指南（2023版）

    中华医学会器官移植学分会王彦峰
    149-161页
    查看更多>>摘要：为指导肾脏移植临床实践，全面提升我国供肾灌注、保存及修复水平，中华医学会器官移植学分会组织相关专家，针对遗体捐献肾脏在体维护、获取灌洗、离体保护3个阶段相关技术的临床问题（包括常温区域灌注、灌注冲洗、静态冷保存、低温机械灌注、低温氧合机械灌注、常温机械灌注等），基于循证医学证据和专家共识，组织制订了《中国遗体捐献肾脏灌注、保存及修复指南（2023版）》。 The Chinese Society of Organ Transplantation has officially released the "Guidelines for Perfusion, Preservation, and Repair of Deceased Donor Kidneys in China (2023 Edition)." This document delineates comprehensive protocols across three critical technical stages: in situ preservation, procurement flushing, and ex vivo preservation of donor kidneys. Key topics addressed include normothermic regional perfusion, perfusion flushing, static cold storage, hypothermic machine perfusion, hypothermic oxygenated machine perfusion, and normothermic machine perfusion. These guidelines are grounded in evidence-based medicine and expert consensus. They aim to enhance clinical practices in kidney transplantation by providing precise, evidence-supported recommendations that improve the techniques of kidney perfusion, preservation, and repair across the nation.

    肾移植遗体捐献器官保存机械灌注

      原文链接:
    • 万方数据

    基于常温机械灌注的器官医学及器官隔离保护治疗在不同研究领域中的应用

    邱江陈海威余双进
    162-166页
    查看更多>>摘要：常温机械灌注（normothermic machine perfusion，NMP）目前是移植领域器官保存的研究热点，其在器官保存的安全性和有效性方面已经得到临床验证，并已应用于器官保存，尤其是边缘供器官的保存。此外，NMP在器官体外功能评估和维护、器官损伤修复等方面的潜在独特优势在未来可能会大大扩展其应用场景，尤其是在器官医学领域，即通过体外器官支持系统精准地对在体或离体器官进行临床干预或研究。借助体外器官支持系统，可以更为高效、安全地对单个或多个器官建立独立的体外循环系统，对靶器官进行生理支持治疗或其他干预治疗，包括器官基因编辑治疗、器官细胞治疗、器官化疗、器官溶瘤病毒治疗及器官生理支持治疗等，也称为器官隔离治疗。这一理论的出现为临床器官疾病治疗提供了全新的治疗思路及手段。本文现就基于NMP技术的器官医学理念及器官隔离保护治疗在器官移植及其他研究领域的应用进行评述。 Normothermic machine perfusion (NMP) is currently a research hotspot of organ preservation in the field of transplantation. Its safety and effectiveness of organ preservation have been clinically validated especially for preserving marginal donor organs. Various unique advantages of NMP are offered for in vitro organ function assessments, maintenance and organ injury repairing. Within the field of organ medicine, precise clinical interventions based upon in vivo or in vitro researches are implemented through an in vitro organ support system. With an aid of extracorporeal organ support system, an independent extracorporeal circulation system could be established for single or multiple organs more efficiently and safely. And physiological supports and other interventions for target organs are performed. Organ gene editing therapy, organ cell therapy, organ chemotherapy, organolytic virus therapy and organ physiological support therapy are all disciplines of organ quarantine therapy. This emerging theory provides a novel treatment for clinical organ diseases. This review summarized the use of NMP technology based upon the concepts and applications of organ medicine. Also the applications of organ isolation and protection therapy were discussed for organ transplantation and other research fields.

    常温机械灌注器官保存器官医学器官隔离保护治疗

      原文链接:
    • 万方数据

    老龄原位心脏移植受者的特点、预后及其相关影响因素单中心分析

    郑珊珊郑哲黄洁廖中凯...
    167-174页
    查看更多>>摘要：目的 探讨老龄心脏移植受者的数量变化趋势和预后情况，并对相关危险因素进行分析。 方法 回顾性分析2004年6月至2021年12月在中国医学科学院阜外医院进行心脏移植的1 044例年龄≥18岁受者的临床资料及年龄分布情况。根据心脏移植时受者年龄是否大于60岁，分为老龄组（≥60岁，877例）和非老龄组（<60岁，157例），再将老龄组受者按<65岁（107例）及≥65岁（50例）进行亚组分析，分别比较上述各组供者的基线资料及受者的基线资料、临床资料、术后院内及术后1年病死率和远期生存率。进一步分析非老龄组、老龄组中<65岁和老龄组中≥65岁受者的远期生存差异。采用logistic回归模型和Cox比例风险回归模型分析全部纳入研究受者心脏移植术后短期病死率和累积生存率的相关危险因素。采用Kaplan-Meier法绘制生存曲线，比较采用Log-rank检验。采用多变量logistic回归模型对短期病死率的相关危险因素进行分析，采用多变量Cox比例风险回归模型对累积生存率的相关危险因素进行分析，在校正其他混杂因素的前提下，以确定受者年龄对心脏移植术后生存的影响。 结果 本中心每年接受移植手术的老龄受者例数均有所增加，而成年心脏移植受者的平均年龄及老龄受者的平均年龄相对稳定。本研究的中位随访时间为6.5年。基线资料方面，老龄组受者与非老龄组男性[84.7%（113/157）比77.5%（687/877）]，有高血压[20.4%（32/157）比8.9%（79/877）]、吸烟[47.1%（74/157）比36.1%（320/877）]、糖尿病史[33.8%（53/157）比14.7%（130/877）]，术前植入转复除颤器/心脏再同步化治疗起搏器/心脏再同步化治疗除颤器（ICD/CRT/CRT-D）比例[28.0%（44/157）比18.0%（160/877）]和术前肌酐[（105.3±25.3）μmol/L比（96.8±35.0）μmol/L]、IMPACT评分[（6.9±2.4）分比（4.2±2.9）分]、血清总胆红素[19.7（13.6，30.3）μmol/L比23.7（15.8，36.8）μmol/L]、平均肺动脉压[（26.0±10.3）mmHg比（29.7±11.0）mmHg（1 mmHg=0.133 kPa）]、供体心脏冷缺血时间[（274.7±105.6）min比（296.0±120.4）min]比较，差异均有统计学意义（P值均<0.05）。老龄组和非老龄组院内病死率[4.5%（7/157）比4.7%（42/887）]和1年病死率[5.7%（9/157）比6.5%（58/887）]比较，差异无统计学意义（P=0.88和0.70）；老龄组中≥65岁受者的院内和术后1年病死率分别为10.0%（5/50）和14.0%（7/50），高于老龄组中<65岁受者的1.9%（2/107）和1.9%（2/107），且差异均有统计学意义（P=0.02和P<0.01）。Kaplan-Meier生存分析显示，老龄组远期存活率低于非老龄组，且差异有统计学意义（P=0.046）；老龄组中≥65岁受者远期存活率低于非老龄组和老龄组中<65岁受者，且差异有统计学意义（P<0.01）。回归分析结果显示，受者年龄≥65岁、术前肌酐≥133 μmol/L、总胆红素≥25.65 μmol/L、术前ECMO辅助支持是心脏移植短期和长期死亡的独立危险因素。 结论 虽然老龄受者的长期预后略差于非老龄受者，但合并症少、术前状态较好的老龄受者院内病死率和术后1年病死率与非老龄受者相近，不应仅根据年龄将老龄受者常规排除在移植之外。年龄≥65岁受者的移植中远期预后不佳，在进行移植决策时需慎重。 Objective To explore the trends and outcomes for heart transplantation (HT) in elderly recipients and further examine the related risk factors. Methods Between June 2004 and December 2021, retrospective review was conducted for the relevant clinical data and age distribution of 1044 HT recipients aged ≥18 year at Fuwai Hospital. The study population was assigned into two groups of elder (≥60 year, n=877) and non-elder (<60 year, n=157). Subgroup analysis was made between recipients aged <65 year (n=107) and those aged ≥ 65 year (n=50) in elder group. Baseline demographic profiles, clinical data, in-hospital and one-year post-transplant mortality and long-term survival were compared between two groups. Then a further comparison of long-term survival was conducted among the groups of non-elder, elder aged <65 year and elder aged ≥65 year. Cox proportional risk regression and multivariate Logistic regression models were utilized for examining the relevant risk factors for cumulative survival rate and short-term mortality. Kaplan-Meier analysis was employed for plotting survival curves and Log-rank test for comparison. Multivariate Cox proportional risk regression model was utilized for examining the relevant risk factors for cumulative survival rate and multivariate Logistic regression model for analyzing the relevant risk factors for short-term mortality. After adjusting for other confounding factors, the impact of recipient age on survival post-HT was determined. Results The number of elderly HT recipients spiked annually at our center while average age of adult recipients and average age of elderly recipients have remained relatively constant. The median follow-up period was 6.5 years. Regarding baseline data, statistically significant differences existed in ratio of males [84.7%(113/157) vs 77.5%(687/877)], hypertension history [20.4%(32/157) vs 8.9%(79/877)], smoking history [47.1%(74/157) vs 36.1%(320/877)], diabetic history [33.8%(53/157) vs 14.7%(130/877)], preoperative ICD/CRT/CRT-D implantation [28.0%(44/157) vs 18.0%(160/877)], value of creatinine [(105.3±25.3) vs (96.8±35.0) μmol/L], IMPACT score [(6.9±2.4) vs (4.2±2.9) point], serum total bilirubin [19.7(13.6, 30.3) vs 23.7(15.8, 36.8) μmol/L], mean pulmonary arterial pressure [(26.0±10.3) vs (29.7±11.0) mmHg (1 mmHg=0.133 kPa)] and ischemic duration [(274.7±105.6) vs (296.0±120.4) min] (allP<0.05). No significant inter-group difference existed in in-hospital mortality [4.5%(7/157) vs 4.7%(42/887)] or 1-year mortality [5.7%(9/157) vs 6.5%(58/887)] (P=0.88, P=0.70) in-hospital mortality and 1-year postoperative mortality of recipients aged ≥65 years 10.0%(5/50) and 14.0%(7/50) were both higher than those aged <65 year [1.9%(2/107), 1.9%(2/107)]. The differences were both statistically significant ( P=0.02, P<0.01). Kaplan-Meier survival analysis indicated that long-term survival rate was lower in elder group than that in non-elder group and the difference was statistically significant (P=0.046). Long-term survival rate of elders aged ≥65 year was lower than that of non-elders aged <65 year and the difference was statistically significant ( P<0.01). Regression analysis indicated that age of recipient ≥65 year, preoperative creatinine ≥133 μmol/L, preoperative total bilirubin ≥25.65 μmol/L and preoperative support of extracorporeal membrane oxygenation (ECMO) were independent risk factors for short/long-term mortality post-HT. Conclusion Although long-term prognosis of elderly recipients is slightly worse than that of non-elderly ones, in-hospital mortality and one-year postoperative mortality are similar between two groups. For elderly recipients with fewer comorbidities and better preoperative status, they should not be excluded from HT based solely upon age. The long-term prognosis of recipients aged ≥65 year remains poor and HT decisions should be made carefully.

    心脏移植老年人受者生存分析危险因素

      原文链接:
    • 万方数据

    肝癌肝移植后复发的文献计量和可视化分析

    周效竹刘冉佳张颖武一...
    175-183页
    查看更多>>摘要：目的 分析全球肝癌肝移植后复发领域的研究现状、热点和前沿。 方法 文献计量学研究。以Web of Science核心合集为数据来源，检索并收集1992年1月至2023年10月肝癌肝移植后复发相关文献，对发表国家/地区、发文期刊、发文作者和机构、引文、关键词等进行规范化处理和文献计量学分析，采用Citespace、VOSviewer和Bibliometric.com在线软件进行统计、突现以及共现聚类的可视化分析。 结果 共检索到文献4 936篇，经严格筛选后，1 189篇文献纳入最终分析。1992年至2021年，全球肝癌肝移植后复发领域发文量呈逐年上升趋势，2021年全球范围内和我国发文量均达到高峰（103篇和32篇）；中国在该领域的发文量最多（308篇），且与美国、韩国、日本、加拿大等国家合作较为密切；Liver Transplantation是刊载该领域文献最多的期刊（113篇）；浙江大学是该领域发文量最多的第一作者单位（74篇），浙江大学郑树森院士是该领域发文量最多的学者（76篇）。引文突现检测发现，意大利学者Mazzafeno于2009年发表在The Lancet Oncology的Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria:a retrospective, exploratory analysis一文的突现强度最高（36.98）。关键词突现检测显示，alpha fetoprotein（甲胎蛋白）、model（模型）、validation（验证）、sorafenib（索拉非尼）和risk（风险）是5个目前仍在突现的关键词。关键词共现聚类分析共得到5个聚类，分别为肝癌肝移植后复发药物治疗方案、肝癌肝移植受者选择标准、预后影响因素、复发预测模型的建立与验证和肝癌局部治疗方法。 结论 肝癌肝移植后复发领域在过去30余年间发展迅速，以浙江大学和郑树森院士为代表的我国学者做出了突出贡献。随着学科发展的不断成熟，肝癌肝移植后复发领域的研究热点逐渐从各中心肝癌肝移植经验和受者选择标准的制定，转变为移植后早期复发风险的预测和药物治疗方案的选择。 Objective This study aimed to evaluate the global research landscape, identify trends, and determine hotspots concerning hepatoma recurrence post-liver transplantation. Methods We conducted a bibliometric analysis usinga systematic search was conducted in the Web of Science Core Collection database from Jan. 1992 to Oct. 2023 to identify relevant articles on hepatoma recurrence after liver transplantation. Articles were selected based on inclusion and exclusion criteria and analyzed for publication trends by country/region, journal, author, institution, citation, and keyword. Visualization tools such as Citespace, VOSviewer, and Bibliometric.com were utilized for statistical analysis, identification of emerging trends, and clustering of keyword co-occurrence. Results Out of 4,936 articles retrieved, 1,189 were included in the final analysis. There was a notable increase in publications on hepatoma recurrence following liver transplantation from 1992 to 2021, peaking in 2021 both globally (n=103) and nationally (n=32). China has the largest number of publications in this field (n=308), maintaining significant collaboration with the United States, South Korea, Japan, Canada. 'Liver Transplantation’ journal had the highest number of publications (n=113). Zhejiang University was the leading institution (n=74), with Academician Zheng Shusen being the most prolific scholar (n=76 publications). Citation emergence detection found that Italian scholar Mazzaferro's Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis published on The Lancet Oncology in 2009 had the highest burst strength (36.98). Five bursting keywords were identified: alpha fetoprotein, model, validation, sorafenib, and risk. Cluster analysis of keyword co-occurrence revealed five primary research themes: the medication for hepatocellular carcinoma recurrence after liver transplantation, recipient selection criteria, prognostic factors, development and validation of recurrence prediction model, and local treatments for hepatocellular carcinoma. Conclusions The study underscores rapid advancements in the research on hepatocellular carcinoma recurrence post-liver transplantation over the past three decades, with significant contributions from Chinese scholars, particularly from Zhejiang University and Academician Zheng Shusen. The evolving research hotspots have shifted from transplantation experiences and recipient selection criteria to early post-transplant recurrence risk prediction and therapeutic strategy development.

    肝癌肝移植复发文献计量学研究热点

      原文链接:
    • 万方数据

    应用蛋白A免疫吸附技术清除造血干细胞移植后新生供体特异性抗体促进血小板植入的再生障碍性贫血1例

    李玲李静朱倩周士源...
    184-187页
    查看更多>>摘要：通过回顾2021年3月苏州大学附属第一医院收治的1例重型再生障碍性贫血患者，应用蛋白A免疫吸附（immunoadsorption，IA）技术清除造血干细胞移植后新生供体特异性抗体（donor specific antibody，DSA）促进血小板植入的诊疗过程，探讨IA技术清除单倍体造血干细胞移植后新生DSA的疗效和安全性。 To explore the efficacy and safety of immunoadsorption (IA) in removing de novo donor specific antibody (DSA) after allogeneic hematopoietic stem cell transplantation (HSCT), the relevant clinical data were retrospectively reviewed for one female patient of severe aplastic anemia (SAA). Desensitization treatment with IA after HSCT was offered for removing de novo DSA and ultimately promoting platelet engraftment at First Affiliated Hospital of Soochow University in March 2021.

    再生障碍性贫血免疫吸附单倍体造血干细胞移植供者特异性抗体

      原文链接:
    • 万方数据

    脱敏治疗药物在预致敏肾移植中的应用及进展

    王佳婷胡雨婷丁洁寿张飞...
    188-193页
    查看更多>>摘要：肾移植是治疗终末期肾脏病的主要方式之一，不同中心报道的移植肾10年存活率在75%~80%。研究认为，肾移植是目前降低肾功能衰竭全因死亡率的最佳治疗方式，可明显改善受者生存率与生活质量。预致敏受者由于体内预存有抗人类白细胞抗原抗体，其移植术后发生排斥的风险远高于非致敏受者，但目前随着各类脱敏技术的应用，此类受者的移植率以及术后受者/移植肾存活率已逐渐升高，致敏不再是肾移植的禁忌证。本文主要就预致敏肾移植脱敏治疗药物的进展进行综述和展望。 Kidney transplantation (KT) is one primary treatment of end-stage renal disease (ESRD). As reported by different centers, 10-year survival rate of transplanted kidneys fluctuates from 75% to 80%. Capable of reducing all-cause mortality in renal failure, KT can significantly improve survival rate and quality-of-life of ESRD patients. The risk of post-transplant rejection is much higher in pre-sensitised recipients than in non-sensitised ones due to the pre-existing anti-human leukocyte antigen antibodies. However, with a rapid development of various desensitisation techniques, transplantation rate and postoperative human/kidney survival rate of recipients have been greatly enhanced. And presensitisation is no longer a contraindication to KT. This review focused upon the latest advances in desensitisation therapeutic agents for pre-sensitised KT.

    预致敏肾移植脱敏治疗

      原文链接:
    • 万方数据

    纳米技术在封装胰岛移植物中的研究

    余梓桐张微尘程颖
    194-198页
    查看更多>>摘要：胰岛移植是治疗1型糖尿病的最佳手段，但移植的胰岛细胞容易因免疫反应等原因而大量丢失，导致胰岛移植远期疗效不佳。胰岛封装是将胰岛细胞包裹在半透性的材料中，以达到保护胰岛细胞分泌胰岛素功能、减少胰岛细胞凋亡、减轻免疫反应的作用。而纳米技术能对封装材料进行纳米级控制，更好的"隔离"胰岛细胞和外界环境，是延长胰岛细胞存活时间的关键技术。本文简要介绍了胰岛封装技术及纳米技术，探讨不同纳米技术在封装胰岛移植物的优缺点，并对纳米技术将来在胰岛移植诊断与治疗方面进行展望，旨在延长胰岛细胞存活时间，提高胰岛素的分泌，改善胰岛移植疗效。 Islelet transplantation (IT) is an ideal treatment for type 1 diabetes. However, a large number of transplanted islet cells become lost due to immune responses and other reasons, resulting in a poor long-term efficacy of IT. Islet encapsulation is wrapping islet cells with semi-permeable materials for protecting insulin secretion function by islet cells, reducing islet cell apoptosis and minimizing immune responses. Nanotechnology enables a nanoscale control of encapsulated materials. A better "isolation" of islet cells and external environment is essential for prolonging the survival time of islet cells. This review summarized the advantages and disadvantages of different nanotechnologies in encapsulating IT for the goals of prolonging the survival of islet cells, improving insulin secretion and boosting the efficacy of IT.

    纳米技术胰岛移植胰岛封装免疫隔离

      原文链接:
    • 万方数据

    更正

    198页
    查看更多>>摘要：本刊2023年第44卷第12期刊发的《靶向IL-6及其受体治疗抗体介导的排斥反应的临床研究进展》一文第762页左栏第一自然段中"另一项单中心随机对照试验中纳入了20例DSA阳性的儿童移植受者，行克拉扎珠单抗治疗后，受者DSA显著降低，肾小球滤过率下降斜率改善，其中18例在术后1年时接受了移植肾活检，7例（38.9%）的分子AMR评分为阴性，5例（27.8%）C4d内凹消失，4例（22.2%）的形态学AMR活性消失，提示克拉扎珠单抗可能对减缓AMR进展有潜在帮助[44]。"一句应为"另一项单中心随机对照试验中纳入了20例DSA阳性的AMR成人肾移植受者，经克拉扎珠单抗治疗后，受者DSA显著降低，肾小球滤过率下降斜率显著改善；其中18例在术后1年时接受了移植肾活检，7例（38.9%）分子形态学AMR评分为阴性，5例（27.8%）毛细血管C4d沉积物消失，4例（22.2%）形态学上由活动性AMR向非活动性转变，提示克拉扎珠单抗可能对减缓AMR进展有潜在帮助[44]。"
      原文链接:
    • 万方数据