2024-04-11 16:39:47来源:中华医学会器官移植学分会阅读:565次
《中国肾脏移植临床诊疗指南》之59
肾脏移植受者EB病毒感染和淋巴增生性疾病临床诊疗指南
中华医学会器官移植学分会
一、指南形成方法
表1 2009 牛津大学证据分级与推荐意见强度分级标准
二、EBV概述和流行病学特点
三、EBV原发性感染/再激活的风险因素
四、EBV感染临床表现
五、EBV 相关检测
六、EBV感染的预防
七、基于EBV监测的抢先治疗
八、 PTLD概述和流行病学特点
2022年第五版WHO将多种免疫缺陷/失调疾病或状态,包括原发性免疫缺陷、HIV感染、移植后和其他医源性免疫缺陷等引起的淋巴增殖性疾病统称为免疫缺陷和失调相关淋巴细胞增生和淋巴瘤,其标准化命名法包括组织学诊断、关联病毒、临床环境/免疫缺陷背景等三部分(表2)[39]。但由于目前免疫缺陷/失调引起淋巴细胞增生性疾病和淋巴瘤的发病机制各不相同、治疗策略也各有其特点和重点,且2022年国际共识分类(ICC)保留了2017年PTLD分类等因素[40],为方便叙述起见,本文仍沿用2017年WHO分类的PTLD分型(表3)。
表2 2022WHO第五版免疫缺陷和失调相关淋巴细胞增生性疾病和淋巴瘤的三部分命名法
表3 2017 年WHO 的PTLD 组织学分类
九、肾脏移植受者发生EBV-PTLD的危险因素
十、EBV-PTLD临床表现
十一、影像学评估
十二、组织病理学
十三、PTLD分期
十四、EBV-PTLD治疗
十五、 PTLD疗效评估
十六、小结
执笔作者:杨华(江西省人民医院(南昌医学院第一附属医院)),丁伟荣(江西省人民医院(南昌医学院第一附属医院)),张伟杰(华中科技大学同济医学院附属同济医院),戎瑞明(复旦大学附属中山医院),金成豪(江西省人民医院(南昌医学院第一附属医院))
通信作者:
李新长(江西省人民医院(南昌医学院第一附属医院))
Email: lxzh863@126.com
薛武军(西安交通大学第一附属医院)
Email: xwujun126@xjtu.edu.cn
门同义(内蒙古医科大学附属医院)
Email: menty85788@163.com
主审专家:薛武军(西安交通大学第一附属医院),门同义(内蒙古医科大学附属医院),朱有华(海军军医大学附属长海医院),陈刚(华中科技大学同济医学院附属同济医院)
审稿专家(按姓氏笔画排序):丁小明(西安交通大学第一附属医院),丰贵文(郑州大学第一医院),宋文利(天津市第一中心医院),王祥慧(上海市交通大学医学院附属瑞金医院),陈劲松(东部战区总医院),孙启全(广东省人民医院),戎瑞明(复旦大学附属中山医院),吴建永(浙江大学医学院附属第一医院),张伟杰(华中科技大学同济医学院附属同济医院),张雷(海军军医大学附属长海医院),李新长(江西省人民医院(南昌医学院第一附属医院)),苗芸(南方医科大学附属南方医院),周洪澜(吉林大学第一医院),金海龙(解放军总医院第八医学中心),金成豪(江西省人民医院(南昌医学院第一附属医院),黄刚(中山大学附属第一医院)
利益冲突:所有作者声明无利益冲突。
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