Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients: A Guidance Report and Clinical Checklist by the Consensus on Managing Modifiable Risk in Transplantation (COMMIT) Group.
Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes.COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant.The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting.
1 Liver Unit, Queen Elizabeth Hospital Birmingham, United Kingdom. 2 Department of General and Visceral Surgery, Frankfurt University Hospital and Clinics, Germany. 3 Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Campus Gasthuisberg, Belgium. 4 Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy. 5 Renal Transplantation Unit, Department of Surgical Science, Università Cattolica Sacro Cuore, Rome, Italy. 6 Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Switzerland. 7 Department of Public Health, Faculty of Medicine, Centre for Health Services and Nursing Research, KU Leuven, Belgium. 8 Department of Hepatology and Liver Transplant Unit, Henri Mondor Hospital (AP-HP), Paris-Est University (UPEC), France. 9 Department of Nephrology, University of Glasgow, United Kingdom. 10 Department of Nephrology and Organ Transplantation, CHU Rangueil, Université Paul Sabatier, Toulouse, France. 11 Vth Department of Medicine & Renal Transplant Program, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium. 14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. 16 Hepatobiliary Centre, Hospital Paul-Brousse (AP-HP), Paris-Sud University, Université Paris-Saclay, Villejuif, France. 17 Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Austria. 18 Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Spain. 19 Transplant Center, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. 20 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy. 21 Department of Hospital Pharmacy and Internal Medicine, Erasmus MC, the Netherlands.
James M
JM
Neuberger
Wolf O
WO
Bechstein
Dirk R J
DR
Kuypers
Patrizia
P
Burra
Franco
F
Citterio
Sabina
S
De Geest
Christophe
C
Duvoux
Alan G
AG
Jardine
Nassim
N
Kamar
Bernhard K
BK
Krämer
Herold J
HJ
Metselaar
Frederik
F
Nevens
Jacques
J
Pirenne
Manuel L
ML
Rodríguez-Perálvarez
Didier
D
Samuel
Stefan
S
Schneeberger
Daniel
D
Serón
Pavel
P
Trunečka
Giuseppe
G
Tisone
Teun
T
van Gelder
D000359:Aftercare / Q000379:methods* / Q000592:standards; D057189:Checklist; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000401:mortality; D016031:Liver Transplantation / Q000401:mortality; D055118:Medication Adherence; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors
D007166:Immunosuppressive Agents