• 摘要: 活体肝移植作为解决器官供需矛盾的主要手段之一,在临床实践中常面临移植物体积不足可能导致受者出现小肝综合征的问题;而若移植物占比大,切取后剩余肝脏体积过小,则可能增加供者术后发生肝功能不全甚至肝衰竭风险。为应对这一双重挑战,双供者肝移植技术应运而生。该技术在最大限度减少单个供者肝脏切除体积、保障供者手术安全的同时,能够通过两份移植物为受者提供足够体积的功能性肝组织,从而提高受者术后肝功能恢复的成功率。然而,目前双供者肝移植在我国的临床应用仍较为有限。为推动该技术在国内的规范化和推广应用,进一步缓解器官短缺问题,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组织国内肝移植领域的专家学者,结合国际先进移植中心的成熟经验,并采用牛津循证医学中心证据质量与推荐强度分级标准,从供者及移植物的评估与选择、手术方式的实施到术后并发症的防治等方面,制订《中国双供者肝移植临床实践指南(2025版)》。该指南旨在为临床提供科学、系统的指导,提升我国双供者肝移植的整体水平,为拓展器官供者来源、保障移植安全与疗效提供有力支持。

     

    Abstract: Living donor liver transplantation, as one of the main approaches to address the imbalance between organ supply and demand, often faces the clinical challenge of insufficient graft volume, which may lead to small‑for‑size syndrome in recipients. Conversely, if the graft volume is too large, resulting in an excessively small remnant liver in the donor after resection, it may increase the risk of postoperative liver dysfunction or even liver failure in the donor. To overcome these challenges, dual‑graft liver transplantation (DGLT) has emerged as an effective surgical approach. This technique minimizes the resection volume of a single donor liver while ensuring donor surgical safety. Simultaneously, it provides the recipient with sufficient volume of functional liver tissue through dual partial grafts, thereby enhancing the success rate of postoperative liver function recovery. However, the clinical application of DGLT remains relatively limited in China. To promote its standar-dized implementation and wider adoption, and to further alleviate organ shortages, the Liver Trans-plantation Group, Branch of Organ Transplantation of Chinese Medical Association and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association have jointly convened domestic experts in liver transplantation. Drawing on the mature experience of leading international trans-plant centers and following the Oxford Centre for Evidence‑Based Medicine grading system for levels of evidence and strength of recommendations, the expert panel develop the Chinese clinical practice guidelines for dual‑graft liver transplantation (2025 edition) from the evaluation and selection of donors and transplants, implementation of surgical methods to prevention and treatment of post-operative complications. This guideline aims to provide scientific and systematic clinical guidance, improve the overall level of DGLT in China, and offer strong support for expanding donor sources while ensuring transplant safety and efficacy.

     

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