Canadian Forum on Combined Organ Transplantation

被引:9
作者
Cantarovich, Marcelo [1 ]
Blydt-Hansen, Tom D. [2 ]
Gill, John [3 ]
Tinckam, Kathryn [4 ,5 ]
Schiff, Jeffrey [4 ,5 ]
Alwayn, Ian [6 ]
Bain, Vince [7 ]
Dipchand, Anne I. [8 ]
Isaac, Debra [9 ]
Kim, S. Joseph [4 ,5 ]
Lien, Dale [10 ]
Zaltzman, Jeffrey [11 ]
Young, Kimberly [5 ]
Nickerson, Peter [5 ,12 ]
机构
[1] McGill Univ, Dept Med, Ctr Hlth, Div Nephrol,Multiorgan Transplant Program, Montreal, PQ, Canada
[2] Univ British Columbia, Div Pediat Nephrol, Vancouver, BC V5Z 1M9, Canada
[3] St Pauls Hosp, Dept Med, Div Nephrol, Vancouver, BC V6Z 1Y6, Canada
[4] Toronto Gen Hosp, Dept Med, Univ Hlth Network, Div Nephrol,Multiorgan Transplant Program, Toronto, ON M5G 1L7, Canada
[5] Canadian Blood Serv Donat & Transplantat, Edmonton, AB, Canada
[6] Dalhousie Univ, Queen Elisabeth II Hlth Sci Ctr, Div Surg, Multiorgan Transplant Program, Halifax, NS, Canada
[7] Univ Alberta Hosp, Dept Med, Liver Transplant Program, Div Gastroenterol, Edmonton, AB T6G 2B7, Canada
[8] Univ Toronto, Hosp Sick Children, Labatt Family Heart Ctr, Dept Paediat, Toronto, ON M5G 1X8, Canada
[9] Alberta Hlth Serv, Div Cardiol, Dept Med, Multiorgan Transplant Program, Calgary, AB, Canada
[10] Univ Alberta Hosp, Lung Transplant Program, Dept Med, Div Pulm Med, Edmonton, AB T6G 2B7, Canada
[11] Univ Toronto, St Michaels Hosp, Dept Med, Div Nephrol, Toronto, ON M5B 1W8, Canada
[12] Univ Manitoba, Dept Med, Div Nephrol, Winnipeg, MB, Canada
关键词
STAGE RENAL-DISEASE; LIVER-KIDNEY TRANSPLANTATION; HEART-TRANSPLANT; RECIPIENTS; SURVIVAL; RISK; DIALYSIS; FAILURE; ESRD;
D O I
10.1097/TP.0000000000000963
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The Canadian Society of Transplantation and Canadian Blood Services conducted a consensus forum on combined renal/nonrenal transplants, as they are not part of Canadian organ-specific allocation models at present. The purpose of this initiative was to make recommendations, develop eligibility criteria, and a decision-making model on listing and allocation. Forty-two participants with expertise in combined transplantation participated in the consensus forum. The United States and Canadian data were reviewed. The consensus forum made recommendations regarding the following: (1) investigation of etiology, severity, duration, and level of renal dysfunction; (2) documentation of degree of nonreversible kidney injury; (3) eligibility for combined (either simultaneous or staged) transplantation; (4) research. Key recommendations were: (1) patients with end-stage nonrenal disease with estimated glomerular filtration rate less than 30 mL/min per 1.73 m(2) for longer than 1 month or on dialysis less than 3 months, who fulfill criteria for nonreversibility of renal dysfunction (by level and duration of renal dysfunction, imaging, and pathology findings), would be eligible for combined renal/nonrenal transplantation; (2) patients on dialysis longer than 3 months would be eligible for combined renal/nonrenal transplantation; (3) staged renal after nonrenal transplantation with subsequent prioritized allocation of renal transplant was endorsed in selected cases. The validation and impact of these recommendations on allocation will require further studies.
引用
收藏
页码:1339 / 1348
页数:10
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