‘Diagnosis and management of asymptomatic bacteriuria in adult kidney transplant recipients’ Survey
A survey was circulated to physicians taking care of adult kidney transplant recipients on a regular basis and working in Europe. The survey was aimed at identifying the current practice in Europe regarding diagnosis and management of asymptomatic bacteriuria (i.e., bacteriuria without symptoms or signs suggestive of urinary tract infection) after adult kidney transplantation. The survey was designed in collaboration with ESGICH Working Group (European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Infections in Compromised Hosts). Survey coordinator is Dr Julien Coussement.
Diagnosis and management of asymptomatic bacteriuria in kidney transplant recipients: a survey of current practice in Europe
Julien Coussement, Umberto Maggiore, Oriol Manuel, Anne Scemla, Francisco López-Medrano, Evi V Nagler, José María Aguado, Daniel Abramowicz, European Renal Association-European Dialysis Transplant Association (ERA-EDTA) Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) working group and the European Study Group for Infections in Compromised Hosts (ESGICH) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
The group launched a Europe-wide survey to assess the frequency of operational tolerance among kidney recipients. Operational Tolerance (opTOL) refers to a state of prolonged allograft survival in the absence of any immunosuppressive drugs or generalized immunodeficiency and is deemed to be extremely rare in kidney transplantation. 17 coordinators were recruited for 27 countries through the ERA-EDTA-DESCARTES working group. They sent a questionnaire to 256 transplant centres to identify tolerant or almost tolerant patients.
The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients. Nephrol Dial Transplant 2016;31(6):1002-13.).
Action plan for the work-up on the young (agedIt is DESCARTES’ impression that the workup of young transplant candidates without comorbidities could be simplified and expedited more rapidly than is sometimes done. L. Hilbrands, U. Heemann, and G. Oniscu have completed a list of examinations that are felt necessary to establish whether or not the candidate is suitable for surgery. The list includes lab examinations, imaging, function tests, and referrals. On the contrary, it is not meant to include all diagnostic examinations made with the purpose of risk stratification (eg. anti-HLA antibodies/typing, CMV and EBV serum status). Each Descartes board member asked the clinical head of selected Transplant Units of his country for comments on this list. The results have been documented in a paper ‘Standard work-up of the low-risk kidney transplant candidate – A European expert survey of the ERA/EDTA DESCARTES Working group’. The paper was submitted to NDT, and will be resubmitted shortly with minor modifications after a prior major revision.
European Renal Best Practice (ERBP) under the auspices of ERA-EDTA has prepared guidelines concerning the evaluation and preparation of donor and recipient of a kidney transplant, in the pre-transplant and peri-operative period. During the spring of 2013 members of ERA-EDTA as well as members of the Descartes working group were invited to review these guidelines. A total of 675 responded and the guidelines have now been finalized and are to be published in the August issue of NDT. The Descartes Board wishes to thank all Descartes working group members participating in the review process for their valuable collaboration.
DESCARTES in collaboration with European Renal Best Practice (ERBP) worked on guidelines for pre-emptive living donor transplantation. The working group was chaired by Wim Van Biesen from ERBP and includes Maria Haller from ERBP method support team, Daniel Abramowicz, Umberto Maggiore, Rainer Oberbauer, and Marc Hazzan all from DESCARTES as well as Pierre Cochat and Licia Perizzi both paediatric nephrologists. The guidelines are currently under submission
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