1 Liver Unit, Queen Elizabeth Hospital Birmingham, United Kingdom. 2 Department of General and Visceral Surgery, Frankfurt University Hospital and Clinics, Germany. 3 Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Campus Gasthuisberg, Belgium. 4 Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy. 5 Renal Transplantation Unit, Department of Surgical Science, Università Cattolica Sacro Cuore, Rome, Italy. 6 Department of Public Health, Faculty of Medicine, Institute of Nursing Science, University of Basel, Switzerland. 7 Department of Public Health, Faculty of Medicine, Centre for Health Services and Nursing Research, KU Leuven, Belgium. 8 Department of Hepatology and Liver Transplant Unit, Henri Mondor Hospital (AP-HP), Paris-Est University (UPEC), France. 9 Department of Nephrology, University of Glasgow, United Kingdom. 10 Department of Nephrology and Organ Transplantation, CHU Rangueil, Université Paul Sabatier, Toulouse, France. 11 Vth Department of Medicine & Renal Transplant Program, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium. 14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. 16 Hepatobiliary Centre, Hospital Paul-Brousse (AP-HP), Paris-Sud University, Université Paris-Saclay, Villejuif, France. 17 Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Austria. 18 Nephrology Department, Hospital Vall d'Hebrón, Autonomous University of Barcelona, Spain. 19 Transplant Center, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. 20 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Italy. 21 Department of Hospital Pharmacy and Internal Medicine, Erasmus MC, the Netherlands.
Transplantation. 2017 Apr;101(4S Suppl 2):S1-S56. doi: 10.1097/TP.0000000000001651.
Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes.COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant.The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting.
肾和肝移植后的短期患者和移植物预后持续改善，1 年生存率超过 80%；然而，改善长期预后仍然是一个挑战。改善移植物的功能和受者的健康状况不仅可以提高生活质量和延长寿命，还可以减少再次移植的需要，从而增加可用于移植的器官数量。临床移植界需要识别和管理那些可改变的患者因素，以降低移植物衰竭的风险，改善长期预后。COMMIT 成立于 2015 年，由来自欧洲 9 个国家的 20 名领先的肾和肝移植专家组成。该小组的任务是为肾和肝移植患者的长期管理提供专家指导，旨在通过最小化与移植后移植物和患者生存不良相关的可改变风险来改善预后。本增刊的目的是通过讨论现有证据和最佳实践，为那些在术后第一年存活下来的肾和肝移植患者的可改变风险的管理提供具体、实用的建议。此外，提供清单增加了这些建议的临床实用性和可及性，提供了一种系统和有效的方法，在临床环境中对可改变风险进行筛查和监测。
