title: Canadian Forum on Combined Organ Transplantation.
abstract: 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 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.
authors.affiliation: 1 Division of Nephrology, Department of Medicine, Multi-Organ Transplant Program, McGill University Health Center, Montréal, Québec, Canada. 2 Division of Pediatric Nephrology, University of British Columbia, Vancouver, British Columbia, Canada. 3 Division of Nephrology, Department of Medicine, St. Paul's Hospital, Vancouver, British Columbia, Canada. 4 Division of Nephrology, Department of Medicine, Multi-Organ Transplant Program, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. 5 Canadian Blood Services Donation and Transplantation, Edmonton, Alberta, Canada. 6 Division of Surgery, Multi-Organ-Transplant Program, Queen Elisabeth II, Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada. 7 Division of Gastroenterology, Department of Medicine, Liver Transplant Program, University of Alberta Hospital, Edmonton, Alberta, Canada. 8 Department of Paediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. 9 Division of Cardiology, Department of Medicine, Multi-Organ Transplant Program, Alberta Health Services, Calgary, Alberta, Canada. 10 Division of Pulmonary Medicine, Department of Medicine, Lung Transplant Program, University of Alberta Hospital, Edmonton, Alberta, Canada. 11 Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada l2 Division of Nephrology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cantarovich
authors.forename: Tom D
authors.initials: TD
authors.lastname: Blydt-Hansen
authors.forename: John
authors.initials: J
authors.lastname: Gill
authors.forename: Kathryn
authors.initials: K
authors.lastname: Tinckam
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schiff
authors.forename: Ian
authors.initials: I
authors.lastname: Alwayn
authors.forename: Vince
authors.initials: V
authors.lastname: Bain
authors.forename: Anne I
authors.initials: AI
authors.lastname: Dipchand
authors.forename: Debra
authors.initials: D
authors.lastname: Isaac
authors.forename: S Joseph
authors.initials: SJ
authors.lastname: Kim
authors.forename: Dale
authors.initials: D
authors.lastname: Lien
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Zaltzman
authors.forename: Kimberly
authors.initials: K
authors.lastname: Young
authors.forename: Peter
authors.initials: P
authors.lastname: Nickerson
mesh_terms: D002170:Canada; D003657:Decision Making; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000293:injuries; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D016377:Organ Transplantation; D012042:Registries; D006435:Renal Dialysis; D012955:Societies, Medical; D013997:Time Factors; D009927:Tissue and Organ Procurement; D014481:United States