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中华移植杂志(电子版) ›› 2024, Vol. 18 ›› Issue (06) : 346 -354. doi: 10.3877/cma.j.issn.1674-3903.2024.06.003

标准与指南

中国肝移植受者抗胸腺细胞免疫球蛋白临床应用指南
中华医学会器官移植学分会肝移植学组, 中国医师协会器官移植医师分会   
  • 收稿日期:2024-12-17 出版日期:2024-12-25
  • 基金资助:
    国家重点研发计划重点专项(2021YFA1100500)杭州医学院“领军创新团队”器官移植临床研究项目(CXLJ202401)宁波市医疗卫生高端团队重大攻坚项目(2024020818)

Chinese guideline for clinical application of antithymocyte globulin in liver transplant recipients

Transplantation Group, Branch of Organ Transplantation of Chinese Liver, of Organ Transplant Physicians of Chinese Branch   

  • Received:2024-12-17 Published:2024-12-25
引用本文:

中华医学会器官移植学分会肝移植学组, 中国医师协会器官移植医师分会. 中国肝移植受者抗胸腺细胞免疫球蛋白临床应用指南[J/OL]. 中华移植杂志(电子版), 2024, 18(06): 346-354.

Transplantation Group, Branch of Organ Transplantation of Chinese Liver, of Organ Transplant Physicians of Chinese Branch. Chinese guideline for clinical application of antithymocyte globulin in liver transplant recipients[J/OL]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(06): 346-354.

肝移植是终末期肝病最有效的根治性手段。 肝脏存在独特的免疫学微环境,尽管肝移植后排斥反应发生率及严重程度明显低于其他实体器官移植,但排斥反应仍是肝移植术后常见并发症,发生率为15% ~25%,严重影响移植物功能与受者生存。 抗胸腺细胞免疫球蛋白(ATG)是一种纯化的多克隆抗体γ 球蛋白混合物,可用于肾移植、肝移植等实体器官移植中的免疫抑制诱导治疗与抗排斥反应治疗,以提高移植物和受者的存活率。 中华医学会器官移植学分会肝移植学组等组织专家讨论,总结国内外相关研究最新进展,并结合国际指南和临床实践,详细阐述ATG 的作用机制、临床应用场景及使用注意事项,旨在为肝移植受者ATG 临床应用提供指导建议。

Liver transplantation is the most effective treatment for end-stage liver diseases.Although the liver has a unique immunological microenvironment, resulting in significantly lower incidence and severity of rejection after liver transplantation than other solid organ transplantation,rejection remains common, with incidence of 15%-25%.Antithymocyte globulin (ATG) is a concentrated anti-human T-lymphocyte immunoglobulin preparation, which is used in the immunosuppressive induction therapy for the organ transplantation to improve the survival rate of graft and recipient.The Liver Transplantation Group, Branch of Organ Transplantation of Chinese Medical Association organized experts to discuss, summarize the latest progress of relevant research at home and abroad, and elaborate the mechanism, clinical application scenarios and precautions of ATG in combination with international guidelines and clinical practice, aiming to provide guidance and suggestions for clinical application of ATG in liver transplant recipients.

表1 英国牛津大学循证医学中心证据分级和推荐意见强度分级标准
表2 肝移植受者急性排斥反应发生危险因素[24-26]
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