Xu Xi, Lv Tao, Xu Gang, Wei Qiang, Ling Qi, Wei Lin, Li Jianhua, Zhang Jiakai, Cai Yang, Cai Jinzhen, Chen Guihua, Chen Zhishui, Chen Zhonghua, Cheng Ying, Dou Jian, Du Shunda, Du Chengyou, Fu Zhiren, Guo Zhiyong, Gao Lianghui, He Xiaoshun, He Qiang, Huang Lei, Huang Jianzhao, Huo Feng, Jia Changku, Jin Chen, Jiang Wentao, Jiang Jipin, Jiao Zuoyi, Jing Hong-En, Lang Ren, Li Bo, Li Li, Li Ning, Li Qiyong, Li Wengang, Li Yumin, Li Guangming, Liu Jun, Liu Lei, Liu Jingfeng, Liu Lianxin, Liu Zuojin, Lu Shichun, Lu Qian, Lv Ling, Lv Yi, Lv Guoyue, Liang Tingbo, Ming Yingzi, Peng Zhihai, Ran Jianghua, Shi Jun, Sun Beicheng, Sun Chengyi, Sun Xuyong, Sun Yuling, Si Zhongzhou, Shao Yingmei, Song Jiulin, Tao Kaishan, Teng Mujian, Wan Yunle, Wan Xueshuai, Wang Liming, Wen Hao, Wu Gang, Wu Jian, Wu Xiangwei, Wu Zhongjun, Wei Lai, Xu Jian, Xu Jun, Yang Yang, Yang Hongji, Yang Zhanyu, Yang Zhaoxu, Yang Jian, Ye Qifa, Yi Shuhong, Zhou Jian, Zhang Feng, Zhang Lei, Zhang Min, Zhang Wu, Zhang Leida, Zhang Shuijun, Zhao Shunyun, Zheng Hong, Zhong Lin, Zhu Haitao, Zhu Jiye, Zhu Xiaofeng, Zhu Zhijun, Wu Hong, Guo Wenzhi, Wang Zhengxin, Xu Xiao, Yang Jiayin
Liver Transplant Center, Department of General Surgery, West China Hospital of Sichuan University, Chengdu, China.
Laboratory of Liver Transplantation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital of Sichuan University, Chengdu, China.
Hepatobiliary Surg Nutr. 2024 Dec 1;13(6):919-936. doi: 10.21037/hbsn-24-329. Epub 2024 Nov 20.
Minimally invasive surgeries are increasingly central to modern medicine, particularly in liver transplantation. These techniques, which offer reduced trauma, precise operations, minimal bleeding, and swift recovery, are, however, unevenly adopted across China. Only a limited number of centers routinely perform minimally invasive donor hepatectomies, indicating a significant imbalance in the development and application of these advanced procedures. Additionally, there lacks a set of standardized guidelines that are tailored to meet China's unique healthcare challenges and conditions.
In August 2023, the Branch of Organ Transplant of Chinese Medical Association and the Branch of Organ Transplant Physicians of Chinese Medical Doctor Association convened a group of national liver transplantation experts to establish a guideline development committee. This committee conducted a thorough review of relevant literature, evaluated existing guidelines and consensus, and assessed factors such as the evidence base, patient preferences, and the cost-effectiveness of interventions within China. After multiple rounds of discussions, both online and offline, the committee finalized the guidelines.
This collaborative effort led to the creation of the "Chinese guidelines for minimally invasive donor hepatectomy in living donor liver transplantation (2024 edition)". These guidelines address crucial aspects such as the safety and advantages of minimally invasive surgery for living donor liver transplantation, donor selection criteria, anesthesia strategies, surgical technical details, and learning curves associated with these procedures, resulting in a comprehensive set of 26 recommendations.
The formulation of these guidelines represents a significant advancement towards standardizing minimally invasive liver transplantation surgeries in China. They are designed to enhance outcomes for both donors and recipients by synthesizing expert consensus with contemporary research and clinical practices. Moreover, they serve as a crucial reference for surgeons and medical institutions, promoting the refinement and adoption of minimally invasive surgical techniques in liver transplantation.
微创手术在现代医学中日益占据核心地位，尤其是在肝移植领域。这些技术具有创伤小、操作精准、出血少和恢复快等优点，但在中国各地的应用情况并不均衡。只有少数中心常规开展微创供体肝切除术，这表明这些先进手术在发展和应用方面存在显著不平衡。此外，缺乏一套针对中国独特医疗挑战和情况量身定制的标准化指南。
2023年8月，中华医学会器官移植学分会和中国医师协会器官移植医师分会召集了一批全国肝移植专家成立了指南制定委员会。该委员会对相关文献进行了全面审查，评估了现有指南和共识，并评估了中国国内的证据基础、患者偏好以及干预措施的成本效益等因素。经过多轮线上线下讨论，委员会最终确定了这些指南。
这项合作努力促成了《中国活体肝移植供体微创肝切除术指南（2024版）》的制定。这些指南涵盖了活体肝移植微创手术的安全性和优势、供体选择标准、麻醉策略、手术技术细节以及与这些手术相关的学习曲线等关键方面，形成了一套全面的26条推荐意见。
这些指南的制定标志着中国在规范微创肝移植手术方面取得了重大进展。它们旨在通过将专家共识与当代研究及临床实践相结合，提高供体和受体的手术效果。此外，它们为外科医生和医疗机构提供了重要参考，促进了肝移植微创外科技术的完善和应用。
