European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care
European Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care
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DOI：
10.1093/ndt/gfu216
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发表时间：
2015-11-01
影响因子：
6.1
通讯作者：
Nagler, Evi
中科院分区：
文献类型：
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作者：
Abramowicz, Daniel;Cochat, Pierre;Nagler, Evi
欧洲最佳实践指南小组（EBPG）于2000年和2002年发布了评估和选择肾脏供体和肾脏移植候选人以及移植后受者护理的指南。新的欧洲肾脏最佳实践委员会在2009年决定，这些指南需要更新。2009年发布了关于肾移植受者移植后护理的临床实践指南，为了避免在肾脏疾病改善全球结果方面的重复努力，我们在本指南中没有解决这些问题。该指南是按照严格的方法学方法制定的：(i)确定临床问题，（ii）确定问题的优先顺序，（iii）系统的文献综述和对现有证据的批判性评估，以及（iv）根据建议评估、发展和评估等级（GRADE）制定建议和分级。每个建议的强度被评为1或2,1代表“我们推荐”，2代表“我们建议”。此外，每个陈述都被分配了一个证据质量的总体等级：A（高），B（中等），C（低）或D（非常低）。该指南对肾移植候选者以及潜在的已故和活体供体的评估、肾供体和受体的免疫检查以及围手术期受体护理提出了建议。工作组总共发表了112项声明。1级推荐51条（45%），2级推荐18条（16%），未分级推荐43条（38%）。有0（0%）条建议分级为“1A”，15（13%）条为“1B”，19（17%）条为“1C”，17（15%）条为“1D”。无一例（0%）为2A级，1例（0.9%）为2B级，8例（7%）为2C级，9例（8%）为2D级。讨论了证据的局限性，特别是缺乏明确的临床结果试验，并为未来的研究提供了建议。在此，我们就肾移植候选人、潜在的已故和活体供体的评估、供体和受者的免疫检查以及受者的围手术期护理提出了完整的建议。我们希望这份文件能够帮助护理人员提高他们为患者提供的护理质量。完整版本的方法，基本原理和参考文献发表在Nephrol Dial Transplant (2013) 28: i1-i71；Doi:10.1093/ndt/gft218，可从http://www.oxfordjournals.org/our_journals/ndt/era_edta.html免费下载。
The European Best Practice Guideline group (EBPG) issued guidelines on the evaluation and selection of kidney donor and kidney transplant candidates, as well as post-transplant recipient care, in the year 2000 and 2002. The new European Renal Best Practice board decided in 2009 that these guidelines needed updating. In order to avoid duplication of efforts with kidney disease improving global outcomes, which published in 2009 clinical practice guidelines on the post-transplant care of kidney transplant recipients, we did not address these issues in the present guidelines.The guideline was developed following a rigorous methodological approach: (i) identification of clinical questions, (ii) prioritization of questions, (iii) systematic literature review and critical appraisal of available evidence and (iv) formulation of recommendations and grading according to Grades of Recommendation Assessment, Development, and Evaluation (GRADE). The strength of each recommendation is rated 1 or 2, with 1 being a 'We recommend' statement, and 2 being a 'We suggest' statement. In addition, each statement is assigned an overall grade for the quality of evidence: A (high), B (moderate), C (low) or D (very low). The guideline makes recommendations for the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and perioperative recipient care.All together, the work group issued 112 statements. There were 51 (45%) recommendations graded '1', 18 (16%) were graded '2' and 43 (38%) statements were not graded. There were 0 (0%) recommendations graded '1A', 15 (13%) were '1B', 19 (17%) '1C' and 17 (15%) '1D'. None (0%) were graded '2A', 1 (0.9%) was '2B', 8 (7%) were '2C' and 9 (8%) '2D'. Limitations of the evidence, especially the lack of definitive clinical outcome trials, are discussed and suggestions are provided for future research.We present here the complete recommendations about the evaluation of the kidney transplant candidate as well as the potential deceased and living donor, the immunological work-up of kidney donors and recipients and the perioperative recipient care. We hope that this document will help caregivers to improve the quality of care they deliver to patients. The full version with methods, rationale and references is published in Nephrol Dial Transplant (2013) 28: i1-i71; doi:10.1093/ndt/gft218 and can be downloaded freely from http://www.oxfordjournals.org/our_journals/ndt/era_edta.html.