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中华移植杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 257 -265. doi: 10.3877/cma.j.issn.1674-3903.2024.05.001

标准与指南

遗体捐献肾脏获取手术技术操作指南
中华医学会器官移植学分会   
  • 收稿日期:2024-08-09 出版日期:2024-10-25

Guideline for surgical techniques for deceased donor kidney procurement

of Organ Transplantation of Chinese Medical Association Branch   

  • Received:2024-08-09 Published:2024-10-25
引用本文:

中华医学会器官移植学分会. 遗体捐献肾脏获取手术技术操作指南[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 257-265.

of Organ Transplantation of Chinese Medical Association Branch. Guideline for surgical techniques for deceased donor kidney procurement[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(05): 257-265.

成功的遗体捐献肾脏(以下简称供肾)获取是肾移植顺利实施的前提,供肾获取手术必须按照标准化的流程进行。为了供肾获取手术的顺利进行,术者必须具有清晰的解剖概念、良好的空间认知、精湛的手术技巧以及团队的密切配合。为了进一步规范供肾获取手术的技术操作,减少非必要损伤,确保供肾质量,增加供肾利用率,中华医学会器官移植学分会组织器官捐献和移植学专家,汇聚集体对遗体捐献肾脏获取技术涉及的临床问题,基于理论知识、现有操作规范、专家共识和临床实践经验,结合全面、充分和科学的文献检索,进行综合分析、反复讨论论证证据和推荐意见,制订本操作指南,以指导遗体器官捐献和肾移植工作者规范和优化供肾获取手术的管理和流程。

The successful procurement of deceased donor kidney is a prerequisite for a smooth kidney transplantation process. The procurement surgery must be carried out according to standardized procedures. To ensure the smooth progress of the donor kidney procurement surgery, the surgeon must possess:a clear understanding of anatomy, good spatial cognition, exquisite surgical skills, and close teamwork. To further standardize the technical operation of donor kidney procurement surgery, minimize unnecessary damage, ensure the quality of the donor kidneys, and maximize the utilization rate of donor kidneys, the Branch of Organ Transplant of Chinese Medical Association has organized organ donation and transplantation experts to pool collective insights on clinical issues. Drawing upon existing operational standards, expert consensus, and clinical practice experience, along with a thorough scientific literature search, we have synthesized, analyzed, and iteratively discussed the evidence and recommendations for the technique of deceased donor kidney procurement and have formulated this operational guideline to assist organ donation and kidney transplantation professionals in standardizing and optimizing the management and procedures involved in donor kidney procurement surgery.

表1 证据分级与推荐意见强度标准
图1 Cattell-Braasch手法示意图
图2 主动脉插管示意图
图3 主动脉插管及下腔静脉流出道示意图
图4 肾脏游离示意图 注:黑色箭头为输尿管建议离断处
图5 左右肾分离示意图 注:左图虚线为建议静脉离断处,右图虚线为建议动脉离断处
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