An International Conference on the Care of the Kidney Transplant Recipient was convened in Lisbon, Portugal from February 2-4, 2006 under the auspices of the National Kidney Foundation and KDIGO (Kidney Disease: Improving Global Outcomes), and in cooperation with The Transplantation Society. Conference participants included over 100 experts and leaders in kidney transplantation, representing more than 40 countries from around the world, including participants from Africa, Asia, Australia, Europe, North and South America.
The goal of the conference was to define key questions and to develop recommendations to improve the outcomes of kidney transplant recipients worldwide with regard to the following basic medical issues: cardiovascular disease (Work Group I), cancer and infection (Work Group II), and anemia, bone disease, reproductive issues, growth and development (Work Group III). Work Groups I, II, and III addressed the pre- and post-transplant care of kidney transplant recipients by the following components: timelines of pre- and post-transplantation; immunosuppression; level of kidney allograft function; burden of disease (prior history of dialysis or preemptive transplant and how that history affects outcome).
A graft maintenance section (Work Group IV) addressed: 1) recipient (and donor) selection; 2) surgical aspects and immediate post-transplant care of recipients including consideration of minimal surgical infra-structure; 3) immunosuppression including an assessment of the incremental expected value of more complex and expensive regimens in comparison to simpler and less expensive regimens, generics, mid- and long-term immunosuppression, 4) living donor versus deceased donor transplantation; and 5) mid- and long-term post-transplant care and monitoring of allograft function.In addition, conference participants were asked to examine the issue of applicability of the recently published “K/DOQI clinical practice guidelines for chronic kidney disease (CKD)” in renal allograft recipients. Specifically, Work Group V addressed the role of estimates of glomerular filtration rate (GFR) in monitoring kidney function after transplantation, as well as the stratification for intervention according to eGFR values.