成人肝移植受者两性霉素B不同剂型临床合理应用指南(2025版)

Guideline on the clinical rational application of different formulations of amphotericin B for adult liver transplant recipients (2025 edition)

  • 摘要: 肝移植受者围手术期感染发生率高,加强肝移植受者围手术期抗感染管理是保证手术成功、降低病死率和改善受者预后的关键因素之一。两性霉素B是临床治疗侵袭性真菌病广谱强效的多烯类抗真菌药物,主要有两性霉素B脱氧胆酸盐、两性霉素B脂质体、两性霉素B胶状分散体和两性霉素B脂质复合物,后3种为两性霉素B脂质剂型。目前,肝移植受者在围手术期合理应用两性霉素B不同剂型尚缺乏统一标准。因此,中华医学会器官移植学分会围手术期管理学组组织相关专家,遵照循证医学原则,结合相关文献、专家经验和各移植中心的研究结果,制订《成人肝移植受者两性霉素B不同剂型临床合理应用指南(2025版)》。本指南旨在对成人肝移植受者两性霉素B的临床合理应用提出建议,明确两性霉素B不同剂型在肝移植受者侵袭性真菌病治疗的剂型与剂量选择,为该类药物的临床决策与合理应用提供指导意见,提高肝移植受者术后生存率。

     

    Abstract: The incidence of perioperative infection in liver transplant recipients is high, and strengthening the management of perioperative anti‑infection in liver transplant recipients is one of the key factors to ensure surgical success, reduce mortality, and improve recipient prognosis. Amphotericin B is a broad‑spectrum and potent polyene antifungal drug used in clinical treatment of invasive fungal diseases. There are mainly amphotericin B deoxycholate, amphotericin B liposome, amphotericin B gelatinous dispersion, and amphotericin B lipid complex available for clinical use, with the latter three being amphotericin B lipid formulations. At present, there is a lack of unified standards for the rational use of different formulations of amphotericin B during the perioperative period in liver transplant recipients. Therefore, the Perioperative Management Group of Chinese Society of Organ Transplantation organized relevant experts to follow the principles of evidence-based medicine, combined with relevant literature, expert experience, and research results from various transplant centers, to develop the Guideline on the clinical rational application of different formulations of amphotericin B for adult liver transplant recipients (2025 edition). This guideline aims to provide recommendations for the rational clinical use of amphotericin B in adult liver transplant recipients, clarify the dosage form and dose selection of different formulations of amphotericin B for the targeted treatment of invasive fungal diseases in liver transplant recipients, provide guidance for clinical decision‑making and rational use of such drugs, and improve postoperative survival rates of liver transplant recipients.

     

/

返回文章
返回