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Eur Urol Focus. 2018 Mar;4(2):208-215. doi: 10.1016/j.euf.2018.07.014. Epub 2018 Jul 20.

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

Author information

1
Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain. Electronic address: orodriguez@fundacio-puigvert.es.
2
Aix-Marseille University, Marseille, France; Department of Urology & Renal Transplantation, La Conception University Hospital, Assistance-Publique Marseille, France.
3
Department of Nephrology, Charité Medical University Berlin, Berlin, Germany.
4
Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal.
5
Department of Urology and Transplant, St Georges NHS Trust Hospitals, London, UK.
6
Urology Department, Hospital Universitario Ramón y Cajal, Alcalá University, Madrid, Spain.
7
Department of Urology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
8
Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.
9
Department of Urology and Transplant, Guy's & St Thomas' NHS Trust Hospitals, London, UK.
10
Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain.

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.

KEYWORDS:

EAU guidelines; Guidelines; Renal transplantation

PMID:
30033070
DOI:
10.1016/j.euf.2018.07.014
[Indexed for MEDLINE]

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