European Association of Urology Guidelines on Renal Transplantation: Update 2018.

{"article_title":"European Association of Urology Guidelines on Renal Transplantation: Update 2018.","author":"Rodr\u00edguez Faba O, Boissier R, Budde K, Figueiredo A, Taylor CF, Hevia V, Lled\u00f3 Garc\u00eda E, Regele H, Zakri RH, Olsburgh J, Breda A","journal_title":"European urology focus","issn":"2405-4569","isbn":"","publication_date":"2018-03-01","volume":"4","issue":"2","first_page":"208","page_count":"","accession_number":"30033070","doi":"10.1016\/j.euf.2018.07.014","publisher":"Elsevier B.V","doctype":"Guideline","subjects":"Europe; Hand-Assisted Laparoscopy standards; Kidney surgery; Kidney Transplantation methods; Urology organization & administration; Anastomosis, Surgical; Biopsy methods; Biopsy trends; Europe epidemiology; Graft Rejection drug therapy; Graft Rejection prevention & control; Humans; Immunosuppressive Agents therapeutic use; Kidney pathology; Kidney Transplantation adverse effects; Kidney Transplantation standards; Living Donors statistics & numerical data; Minimally Invasive Surgical Procedures methods; Nephrectomy methods; Organ Preservation standards; Stents standards","interest_area":["Urology & Nephrology"],"abstract":"Context: The European Association of Urology (EAU) panel on renal transplantation (RT) has released an updated version of the RT guidelines. Objective: To present the 2018 EAU guidelines on RT. Evidence Acquisition: A broad and comprehensive scoping exercise was performed, encompassing all areas of RT guidelines published between January 1, 2007, and May 31, 2016. Databases covered by the search included Medline, Embase, and the Cochrane Libraries. Previous guidelines were updated, and levels of evidence and grades of recommendation were assigned. Evidence Synthesis: It is strongly recommended to offer pure or hand-assisted laparoscopic\/retroperitoneoscopic surgery as the preferential technique for living donor nephrectomy. Decisions on the acceptance of a donor organ should not be based on histological findings alone since this might lead to an unnecessarily high rate of discarded grafts. For ureterovesical anastomosis, a Lich-Gregoir-like extravesical technique protected by a ureteral stent is the preferred technique for minimisation of urinary tract complications. It is also strongly recommended to perform initial rejection prophylaxis with a combination therapy comprising a calcineurin inhibitor (preferably tacrolimus), mycophenolate, steroids, and an induction agent (either basiliximab or anti-thymocyte globulin). The long version of the guidelines is available at the EAU website (http:\/\/uroweb.org\/guidelines). Conclusions: These abridged EAU guidelines present updated information on the clinical and surgical management of RT for incorporation into clinical practice. Patient Summary: The European Association of Urology has released the renal transplantation guidelines. The implementation of minimally invasive surgery for organ retrieval and the latest evidence on transplant surgery as well as on immunosuppressive regimens are key factors for minimisation of rejection and achievement of long-term graft survival. Copyright \u00a9 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=30033070","isPdfLink":false,"isSAML":false,"an":"30033070","number_other":"","type_pub":"","issn_electronic":"2405-4569","languages":"English","language":"eng","date_entry":"Date Created: 20180724 Date Completed: 20190222 Latest Revision: 20190222","date_update":"20240105","titleSource":"European urology focus [Eur Urol Focus] 2018 Mar; Vol. 4 (2), pp. 208-215. Date of Electronic Publication: 2018 Jul 20.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2018-03-01","description":"Context: The European Association of Urology (EAU) panel on renal transplantation (RT) has released an updated version of the RT guidelines.<br \/>Objective: To present the 2018 EAU guidelines on RT.<br \/>Evidence Acquisition: A broad and comprehensive scoping exercise was performed, encompassing all areas of RT guidelines published between January 1, 2007, and May 31, 2016. Databases covered by the search included Medline, Embase, and the Cochrane Libraries. Previous guidelines were updated, and levels of evidence and grades of recommendation were assigned.<br \/>Evidence Synthesis: It is strongly recommended to offer pure or hand-assisted laparoscopic\/retroperitoneoscopic surgery as the preferential technique for living donor nephrectomy. Decisions on the acceptance of a donor organ should not be based on histological findings alone since this might lead to an unnecessarily high rate of discarded grafts. For ureterovesical anastomosis, a Lich-Gregoir-like extravesical technique protected by a ureteral stent is the preferred technique for minimisation of urinary tract complications. It is also strongly recommended to perform initial rejection prophylaxis with a combination therapy comprising a calcineurin inhibitor (preferably tacrolimus), mycophenolate, steroids, and an induction agent (either basiliximab or anti-thymocyte globulin). The long version of the guidelines is available at the EAU website (http:\/\/uroweb.org\/guidelines).<br \/>Conclusions: These abridged EAU guidelines present updated information on the clinical and surgical management of RT for incorporation into clinical practice.<br \/>Patient Summary: The European Association of Urology has released the renal transplantation guidelines. The implementation of minimally invasive surgery for organ retrieval and the latest evidence on transplant surgery as well as on immunosuppressive regimens are key factors for minimisation of rejection and achievement of long-term graft survival.<br \/> (Copyright © 2018 European Association of Urology. Published by Elsevier B.V. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=30033070&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Rodr\u00edguez Faba O, Boissier R, Budde K, Figueiredo A, Taylor CF, Hevia V, Lled\u00f3 Garc\u00eda E, Regele H, Zakri RH, Olsburgh J, Breda A"}