Clinical guideline for diagnosis and treatment of combined pancreas and kidney transplantation in China

doi:10.3877/cma.j.issn.1674-3903.2024.03.001

Abstract

Abstract:

Diabetes mellitus is a global disease, and China ranks first in the world in terms of the number of adults with diabetes mellitus. Combined pancreas and kidney transplantation, as the most effective treatment for end-stage diabetic nephropathy or diabetes mellitus combined with end-stage renal disease, can achieve the same therapeutic effect in patients with type 1 diabetes mellitus and some patients with type 2 diabetes mellitus. In order to further standardize the clinical diagnosis and treatment of combined pancreas and kidney transplantation, organ transplantation experts from the Branch of Organ Transplantation of Chinese Medical Association formulated the clinical guideline for diagnosis and treatment of combined pancreas and kidney transplantation in China, which is formulated by adopting the 2009 version of the Oxford Centre for Evidence-Based Medicine′s criteria for grading the evidence and the strength of the recommendation. The guideline provides detailed evidence-based recommendations on 32 key clinical issues, including type of combined pancreas and kidney transplantation, indications and contraindications, donor organ and recipient evaluation, organ procurement and repair, selection of surgical procedures, diagnosis and treatment of complications, and recipient follow-up, aiming at guiding the clinical practice through evidence-based guidance to comprehensively improve the diagnosis and treatment of combined pancreas and kidney transplantation in China.

Key words: Combined pancreas and kidney transplantation, Diabetic nephropathy, End-stage renal disease, Guideline, Complication

Branch of Organ Transplantation of Chinese Medical Association, Branch of Kidney Transplantation, China International Exchange and Promotive Association for Medical and Health Care. Clinical guideline for diagnosis and treatment of combined pancreas and kidney transplantation in China[J]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(03): 129-147.

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推荐强度	证据级别	描述
A	1a	RCT的系统评价
	1b	结果可信区间小的RCT
	1c	显示"全或无效应"的任何证据
B	2a	队列研究的系统评价
	2b	单个队列研究(包括低质量的RCT，如失访率>20%)
	2c	基于患者结局的研究
	3a	病例对照研究的系统评价
	3b	单个病例对照研究
C	4	病例系列报告、低质量队列研究和低质量病例对照研究
D	5	专家意见(即无临床研究支持的、仅依据基础研究或临床经验的推测)

推荐强度	证据级别	描述
A	1a	RCT的系统评价
	1b	结果可信区间小的RCT
	1c	显示"全或无效应"的任何证据
B	2a	队列研究的系统评价
	2b	单个队列研究(包括低质量的RCT，如失访率>20%)
	2c	基于患者结局的研究
	3a	病例对照研究的系统评价
	3b	单个病例对照研究
C	4	病例系列报告、低质量队列研究和低质量病例对照研究
D	5	专家意见(即无临床研究支持的、仅依据基础研究或临床经验的推测)

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