Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation

Knoll, Greg; Cockfield, S.; Blydt-Hansen, Tom; Baran, Dana; Kiberd, Bryce A.; Landsberg, David; Rush, David; Cole, Edward

doi:10.1503/cmaj.051291

Cited by 249 publications

(117 citation statements)

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“…Considering only English language publications, seven national guidelines have been identified [4,30,138,[152][153][154][155], six of which relate to SOT and one to HSCT. Some offer guidance on screening of living and deceased donors in addition to screening and management of LTBI and TB in the recipients.…”

Section: Published National Guidelinesmentioning

confidence: 99%

“…Some offer guidance on screening of living and deceased donors in addition to screening and management of LTBI and TB in the recipients. These publications are from the following countries or geographic areas: Canada [152], Europe [153], Spain [30], UK [154], USA [4,155] or global [138]. Four deal specifically with renal transplantation [4,[152][153][154], two with SOT in general [4,30], including some specific information on liver and lung transplants, and one with HSCT [138].…”

Section: Published National Guidelinesmentioning

confidence: 99%

“…These publications are from the following countries or geographic areas: Canada [152], Europe [153], Spain [30], UK [154], USA [4,155] or global [138]. Four deal specifically with renal transplantation [4,[152][153][154], two with SOT in general [4,30], including some specific information on liver and lung transplants, and one with HSCT [138]. In addition, there are four further statements relating to TB and transplantation: one on general testing and treatment of LTBI [156]; a conference update briefly covering cardiac transplantation [157]; a general statement [158]; and a review of the evidence for preventive chemotherapy/chemoprophylaxis [31].…”

Section: Published National Guidelinesmentioning

confidence: 99%

See 2 more Smart Citations

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

Bumbăcea

Arend

Eyüboğlu³

et al. 2012

Eur Respir J

228

261

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Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-c based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking. KEYWORDS: Guideline, management, Mycobacterium tuberculosis, transplantation, tuberculosis T uberculosis (TB) is caused by the pathogenic species of the Mycobacterium tuberculosis complex. Only a minority of individuals who develop an adaptive immune response following infection with M. tuberculosis will ever develop TB, with the actual risk depending on the extent to which the host immune system provides a successful or inadequate response [1,2]. Therefore, individuals with impaired immune response, such as solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients, are more prone to develop TB than immunocompetent persons. TB in transplant recipients is more frequent compared to the general population (estimates from the last decades state 20-74 times as frequent in SOT [3,4] and twice as frequent in HSCT [5]), and more often fatal (up to 31% in SOT [6] and up to 50% in HSCT recipients [7]), thus adding effectiveness to interventions for its prevention, even in the face of difficulties, with treatment related to adverse drug events and drug-drug interactions. Active TB in transplant recipients can result from latent infection with M. tuberculosis (LTBI) in the transplant candidate or in the donor tissue, or from de novo post-transplant infection. These various scenarios prompt for targeted pre-transplant screening of both recipient and, if possible, donors to allow focused management of recipients selected for preventive intervention in the pre-and/or posttransplant period. The term ''preventive chemotherapy'' is used to denote treatmen...

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Section: Published National Guidelinesmentioning

confidence: 99%

Section: Published National Guidelinesmentioning

confidence: 99%

Section: Published National Guidelinesmentioning

confidence: 99%

See 1 more Smart Citation

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

Bumbăcea

Arend

Eyüboğlu³

et al. 2012

Eur Respir J

228

261

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“…Each cancer is different and the stage of the cancer and type of treatment given, as well as the time from the diagnosis to the proposed transplantation need consideration. There are no certain answers to these questions, even when one knows the particular circumstances for an individual recipient, yet each set of transplant assessment clinical practice guidelines provides a clear answer for the most common cancers (Table 2) (Knoll et al 2005;Batabyal et al 2012). The word "guideline" must be respected carefully because these are merely guidelines to the normal behavior of a particular cancer type and the expected outcomes under immunosuppression.…”

Section: The Potential Transplant Recipient With a Preexisting Diagnomentioning

confidence: 99%

“…The major problem with an evidence-based strategy for avoiding the risk of cancer transmission from organ donation has been first that AST, American Society of Transplantation (Kasiske et al 2001); CARI, caring for Australasians with renal impairment (CARI Guidelines 2011); B&D, Bunnapradist and Danovitch (2007); CST, Canadian Society of Nephrology (Knoll et al 2005); EBPG, European Best Practice Guidelines (EBPG 2000); MMOH, Malaysia Ministry of Health (MMOH 2009). there will of course never be a randomized study, and second, the incidence of any cancer transmission is so low that sporadic case reports are the main source of information. The publication bias against single case reports means that this source of data is highly likely to underestimate the true incidence, and the low frequency and very variable stage of cancers mean that definitive risk calculations are impossible.…”

Section: Deceased Donors With a History Of Cancermentioning

confidence: 99%

Cancer in the Transplant Recipient

Chapman

Webster

Wong

2013

Cold Spring Harbor Perspectives in Medicine

234

187

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Malignancy has become one of the three major causes of death after transplantation in the past decade and is thus increasingly important in all organ transplant programs. Death from cardiovascular disease and infection are both decreasing in frequency from a combination of screening, prophylaxis, aggressive risk factor management, and interventional therapies. Cancer, on the other hand, is poorly and expensively screened for; risk factors are mostly elusive and/or hard to impact on except for the use of immunosuppression itself; and finally therapeutic approaches to the transplant recipient with cancer are often nihilistic. This article provides a review of each of the issues as they come to affect transplantation: cancer before wait-listing, cancer transmission from the donor, cancer after transplantation, outcomes of transplant recipients after a diagnosis of cancer, and the role of screening and therapy in reducing the impact of cancer in transplant recipients.

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Assessment of the Potential Renal Transplant Recipient

Mark

Jardine

2012

Handbook of Renal and Pancreatic Transplantation

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Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation

Abstract: The full-text version of the Canadian Society of Transplantation consensus guidelines on eligibility for kidney transplantation is available at www.

Cited by 249 publications

References 1 publication

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

Cancer in the Transplant Recipient

Assessment of the Potential Renal Transplant Recipient

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