Organ donation from deceased children is an important part of deceased organ donation,which significantly differs from adult organ donation.To standardize functional maintenance,evaluation and application of donor kidneys from deceased children,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Guidelines for Functional Maintenance,Evaluation and Application of Donor Kidneys from Deceased Children in China"based on the levels of evidence and strengthens of recommendation of Oxford Center for Evidence-based Medicine of 2009.Regarding 29 clinical problems related to functional maintenance,evaluation and application of donor kidneys from deceased children,33 recommendations were given in this guideline,aiming to standardize the operation process,provide guidance for clinical work and comprehensively enhance the quality of organ donation and transplantation.

The recurrence of primary disease is an important cause affecting the short-term and long-term survival of transplant kidney,which receives increasing attention.Systemic disease-related renal damage may recur after kidney transplantation and cause varying degrees of damage to the transplant kidney.With an in-depth understanding of the pathogenesis of systemic disease-related renal damage,the level of diagnosis and treatment of recurrence of systemic disease-related renal damage in transplant kidney is gradually improving.Branch of Organ Transplantation of Chinese Medical Association organized organ transplantation experts to fully read,analyze,and summarize the current international and domestic literature.On the basis of"Technical Specification for Diagnosis and Treatment of Chronic Renal Allograft Dysfunction(2019 edition)",the risk factors,preventive measures,treatment measures,and prognosis of the recurrence of systemic disease-related renal damage were evaluated based on the Grading of Recommendations Assessment,Development and Evaluation for evidence quality and recommendation strength.The"Guidelines for Clinical Diagnosis and Treatment of Recurrence of Systemic Disease-Related Renal Damage in Transplant Kidney in China"were formulated,which provide recommendations for corresponding clinical issues to better ensure and promote the long-term survival of transplant kidneys and recipients.

In order to promote the standardized application of ex vivo hypothermic machine perfusion preservation technology for donor kidney from deceased organ donation,Branch of Organ Transplantation of Chinese Medical Association organized the formulation of the"Guidelines for ex vivo hypothermic machine perfusion preservation of donor kidney from deceased organ donation in China".This guideline integrates expert consensus from the fields of kidney transplantation and deceased organ donation,based on existing clinical guidelines,systematic reviews,case studies,expert consensus,and other materials,and combined with clinical issues related to ex vivo hypothermic machine perfusion preservation technology for kidneys from deceased organ donation in recent years both domestically and internationally.After multiple expert discussions and reaching a consensus,the guideline was completed.The guideline contains 11 clinical questions and 14 recommendations,and the strength of recommendations and evidence levels for each clinical question have been graded according to the 2009 Oxford Centre for Evidence-Based Medicine levels of evidence and grades of recommendation.This guideline aims to provide guidance for clinical practice,improve the level of donor kidney preservation from deceased organ donation in China,reduce the rate of organ discard,and alleviate the shortage of organs.

Combined liver and kidney transplantation has been steadily applied in major transplantation centers,saving the lives of many patients with end-stage liver and renal failure.However,there are still multiple unresolved problems in the clinical diagnosis,treatment and long-term prognosis of combined liver and kidney transplantation.By referring to"Technical Operating Standards for Combined Liver and Kidney Transplantation(2019 Edition)"and the latest published literature and guidelines at home and abroad,"Guidelines for Clinical Diagnosis and Treatment of Combined Liver and Kidney Transplantation"was formulated.Recommendations and suggestions were delivered regarding the surgical indications and contraindications,preoperative preparation and evaluation,the timing of transplantation for end-stage liver and kidney diseases,the selection of surgical approaches and postoperative follow-up,specific pathophysiology,surgical techniques,complication management and immunosuppressive treatment of combined live and kidney transplantation,aiming to enhance the utilization rate of grafts and improve the survival and prognosis of combined liver and kidney transplant recipients.

Subclinical research of xenotransplantation involves xenotransplantation trial using brain death donors,which is an important intermediate step from basic research and animal experiments to the clinical application of xenotransplantation.It provides necessary data support for the safety and efficacy of xenotransplantation.In order to promote the safe,orderly,scientific and standardized development of subclinical research on xenotransplantation,the Xenotransplantation Group of Branch of Organ Transplantation of Chinese Medical Association formulated the"Expert Consensus on Subclinical Research of Xenotransplantation(2024 Edition)"based on relevant laws and regulations.The consensus includes aspects such as the selection of donor pigs,recipient selection criteria,legal and ethical requirements,determination of trial termination time,family informed consent system,and brain death determination standards.

In recent years,the infection of nontuberculous mycobacterium(NTM)has been increasing rapidly,which captivates widespread attention.The infection rate of NTM in kidney transplant recipients is more significantly elevated due to the impact of immunosuppressive drugs and other factors.However,due to the lack of sufficient research evidence,relevant guidelines for the diagnosis and treatment of NTM after kidney transplantation are still lacking.To further standardize the diagnosis and treatment of NTM disease in kidney transplant recipients,and deepen medical practitioners'understanding and diagnosis and treatment of NTM disease in organ transplantation in China,Branch of Organ Transplantation of Chinese Medical Association organized relevant experts to formulate this guideline by referring to the latest edition of"An official ATS/IDSA statement:diagnosis,treatment,and prevention of nontuberculous mycobacterial diseases","Expert Consensus on the Diagnosis and Treatment of Nontuberculous Mycobacterial Disease",and"Technical Specification for Clinical Diagnosis and Treatment of Nontuberculous Mycobacteria in Organ Transplant Recipients(2019 Edition)",and considering the characteristics of kidney transplant recipients.

Fusarium is the most common mold in clinical practice,which may cause superficial infection in hosts with normal immune function,such as keratitis and severe disseminated infection(primarily manifested as fungemia)in individuals with poor immune function.Prevention and treatment of fusaridiosis are associated with long-term survival of kidney transplant recipients.To promote the standardization of clinical diagnosis and treatment of invasive fusaridiosis in kidney transplant recipients,Branch of Organ Transplantation of Chinese Medical Association initiated and formulated"Guidelines for Clinical Diagnosis and Treatment of Invasive Fusaridiosis in Kidney Transplant Recipients in China".In this guideline,the levels of evidence and strengths of recommendation for each clinical problem were classified using Oxford Center for Evidence-based Medicine of 2009.Regarding 13 clinical problems related to clinical diagnosis and treatment of invasive fusaridiosis after kidney transplantation,14 recommendations were proposed in accordance with clinical diagnosis and treatment practice in China,aiming to promote the standardization of diagnosis and treatment of invasive fusaridiosis after kidney transplantation and improve long-term survival of both recipients and renal allografts after kidney transplantation.

Delayed graft function in kidney transplant recipients is one of the common early complications after kidney transplantation,which is an independent risk factor affecting the short-term and long-term survival of renal allografts.Branch of Organ Transplantation of Chinese Medical Association and Branch of Kidney Transplantation of China International Exchange and Promotive Association for Medical and Health Care organized well-known Chinese experts in organ transplantation and related disciplines to formulate and discuss the determination of the scope and clinical problems,evidence retrieval and screening,and the formation of recommendations based on"Technical Specification for the Diagnosis and Treatment on Delayed Graft Function After Renal Transplantation(2019 edition)".After two rounds of collective examination and approval by Chinese Medical Association and China International Exchange and Promotive Association for Medical and Health Care,"Guidelines for Clinical Diagnosis and Treatment of Delayed Graft Function in Kidney Transplant Recipients in China"was finally formulated.This guideline puts forward recommendations and explanations regarding 21 clinical problems including the concept,mechanism,risk factors,diagnosis,prevention,treatment and application of immunosuppressive drugs for delayed graft function in kidney transplant recipients,aiming to standardize the diagnosis,prevention and treatment of delayed graft function in kidney transplant recipients,enhance clinical efficacy of kidney transplantation,prolong short-term and long-term survival of kidney transplant recipients and renal allografts and promote the development of the discipline of transplantation.

In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China".Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines,systematic evaluations,case studies,expert consensus.The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system,central nervous system,cardiovascular system,ocular,cutaneous and osteoporosis disorders.The full text focuses on 27 clinical problems and forms 40 recommendations,mainly involving the risk factors,classification,diagnosis,treatment and prevention of various complications.This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine(OCEBM)Grading and Strength of Recommendation criteria,so as to provide reference for the diagnosis and treatment of late complications,comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.

The diagnosis and treatment of digestive system complications of kidney transplant recipients is related to the long-term survival and quality of life of patients,which needs great attention.In order to further standardize its diagnosis and treatment,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Digestive System Complications in Kidney Transplant Recipients in China",and organized experts in organ transplantation and related disciplines to summarize the new progress in diagnosis and treatment of digestive system complications of kidney transplant recipients at home and abroad in recent years based on existing clinical research,systematic evaluation,case study,expert consensus and existing guidelines,and reached a consensus after many discussions.This paper focuses on 11 clinical problems,forming 16 recommendations,and grading the evidence quality and recommendation strength of each clinical problem by the evidence grading and recommendation strength standard of Oxford University Evidence-based Medicine Center in 2009,in order to provide reference for the diagnosis and treatment of digestive system complications of kidney transplant recipients,comprehensively improve the management ability of digestive system complications of clinicians in an all-round way and benefit transplant recipients.