Clinical practice guidelines on liver transplantation for nonresectable liver-only colorectal liver me-tastases in China(2023 edition)
中华医学会器官移植学分会 傅志仁 1夏强 2郑虹3
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作者信息
1. 上海交通大学医学院附属瑞金医院,上海200025
2. 上海交通大学医学院附属仁济医院,上海200127
3. 天津市第一中心医院,天津 300192
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摘要
无法行根治性切除或达到无疾病证据(no evidence of disease,NED)状态的结直肠癌肝转移(colorectal liver metastases,CRLM)预后极差,肝移植可能为这些患者带来新的治疗希望.为了推动国内高质量、规范化开展肝移植治疗不可切除的CRLM,中华医学会器官移植学分会组织多学科专家以循证方法学和德尔菲法为指导,围绕肝移植治疗策略下CRLM不可切除性的判定、受者筛选、生物侵袭性评估、肿瘤学治疗和免疫抑制方案以及应对供器官短缺和分配限制的策略进行文献检索、综述和证据综合,经过两次线下会议讨论和两轮专家函询,制定了《中国肝移植治疗不可切除结直肠癌肝转移临床实践指南(2023版)》,为行业内医务人员提供借鉴和参考.
Abstract
The prognosis is notably grim for patients with colorectal liver metastases(CRLM)ineligible for curative resection or achieving a status of no evidence of disease(NED).In this context,liver transplantation emerges as a great beacon of hope.To foster the adoption of high-quality standardized liver transplantation practices for unresectable CRLM across China,Branch of Organ Transplant of Chinese Medical Association has convened a panel of multidisciplinary experts and drafted this guideline after two offline meetings and two rounds of expert inquiries guided by evidence-based methodologies and Delphi process.This guideline focused upon criteria for judging CRLM non-resectability within the context of liver transplantation,selection of candidates,evaluation of tumor aggressiveness,oncological treatment strategies,immunosuppression protocols and tactics for navigating donor scarcity and allocation challenges.It served as a valuable resource and standard for healthcare practitioners in the field.
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