International consensus recommendations for the RAPID procedure in liver transplantation: The RAPID Consensus ISLS 2023 Zurich Collaborative.

IF 12.5 2区医学 Q1 SURGERY

International journal of surgery Pub Date : 2025-04-01 DOI:10.1097/JS9.0000000000002145

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引用次数: 0

Abstract

Introduction: Since its beginning in 1963, liver transplantation has significantly advanced, now including transplant oncology. As indications broaden, donor supply reduces. The two-stage RAPID procedure (initially abbreviated as "Resection And Partial Liver Segment 2/3 Transplantation With Delayed Total Hepatectomy") has emerged to address the use of small-for-size grafts. However, a comprehensive evaluation of RAPID is essential given its novelty, scarcity, and diverse outcomes reported.

Methods: The RAPID Consensus International Society of Liver Surgeons 2023 Zurich initiative established evidence around the RAPID procedure using the Danish Model of Consensus. Engaging an international community of specialists, the initiative ensured multidisciplinary involvement and used the GRADE framework to evaluate the quality of evidence and grade the recommendations.

Results: Comprehensive discussions and debates led to internationally recognized recommendations addressing perioperative measures for RAPID. Key recommendations highlighted the significance of standardized nomenclature, specific indications, graft criteria, surgical techniques, optimal interstage timings, and measures to manage potential complications.

Conclusion: The consensus provides recommendations for the RAPID procedure, emphasizing transparency and outcome reporting. Establishing dedicated registries can improve care standards, which may ensure the benefits of RAPID by maximizing patient safety and improving outcomes.

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关于肝移植中 RAPID 程序的国际共识建议。

自1963年开始，肝移植（LT）有了显著的进展，现在包括移植肿瘤学。随着适应症的扩大，供体供应减少。两阶段快速手术（最初缩写为“切除和部分肝段2/3移植伴延迟全肝切除术”）已经出现，以解决小尺寸（SFS）移植物的使用。然而，鉴于RAPID的新颖性、稀缺性和报告结果的多样性，对其进行全面评估是必不可少的。方法：国际肝脏外科学会（ISLS） 2023苏黎世倡议采用丹麦共识模型建立了RAPID手术的证据。该倡议与国际专家团体合作，确保多学科参与，并使用GRADE框架评估证据质量并对建议进行评级。结果：全面的讨论和辩论导致了国际公认的关于RAPID围手术期措施的建议。主要建议强调了标准化命名、具体适应症、移植物标准、手术技术、最佳期间时机和管理潜在并发症措施的重要性。结论：共识为RAPID程序提供了建议，强调透明度和结果报告。建立专门的登记处可以提高护理标准，从而通过最大限度地提高患者安全和改善结果，确保快速免疫疗法的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of surgery SURGERY-

CiteScore

17.70

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.