Primary Osteoarthritis Early Joint Degeneration Induced by Endoplasmic Reticulum Stress Is Mitigated by Resveratrol.

Increasing numbers of people are living with osteoarthritis (OA) due to aging and obesity, creating an urgent need for effective treatment and preventions. Two top risk factors for OA, age and obesity, are associated with endoplasmic reticulum (ER) stress. The I-ERS mouse, an ER stress-driven model of primary OA, was developed to study the role of ER stress in primary OA susceptibility. The I-ERS mouse has the unique ability to induce ER stress in healthy adult articular chondrocytes and cartilage, driving joint degeneration that mimics early primary OA. In this study, ER stress-induced damage occurred gradually and stimulated joint degeneration with OA characteristics including increased matrix metalloproteinase activity, inflammation, senescence, chondrocyte death, decreased proteoglycans, autophagy block, and gait dysfunction. Consistent with human OA, intense exercise hastened and increased the level of ER stress-induced joint damage. Notably, loss of a critical ER stress response protein (CHOP) largely ameliorated ER stress-stimulated OA outcomes including preserving proteoglycan content, reducing inflammation, and relieving autophagy block. Resveratrol diminished ER stress-induced joint degeneration by decreasing CHOP, TNFα, IL-1ß, MMP-13, pS6, number of TUNEL-positive chondrocytes, and senescence marker p16 INK4a. The finding, that a dietary supplement can prevent ER stressed-induced joint degeneration in mice, provides a preclinical foundation to potentially develop a prevention strategy for those at high risk to develop OA.

Impact of treatment modality on pelvic floor dysfunction among uterine cancer survivors.

OBJECTIVE: Pelvic floor dysfunction is a common adverse effect of uterine cancer treatment. In this study we compared patient-reported outcomes regarding pelvic floor dysfunction among uterine cancer survivors after hysterectomy and bilateral salpingo-oophorectomy, surgery and brachytherapy, or surgery and external beam radiotherapy with or without brachytherapy versus women who had a hysterectomy for benign indications. METHODS: We used the validated 20-item Pelvic Floor Distress Inventory to assess lower urinary distress, colorectal distress, and pelvic organ prolapse dysfunction in each treatment group. Pelvic floor dysfunction-related quality of life in these domains was compared across treatment modalities using the Pelvic Floor Impact Questionnaire-7. Treatment type, body mass index, comorbidities, and number of vaginal births were obtained from medical records. A zero-inflated negative binomial regression model was used to assess the association of treatment regimens and covariates relative to the non-cancer cohort. RESULTS: A total of 309 surveys were analyzed. The median age of the patients at surgery was 58 years (range 20-87) and the median age at survey completion was 66 years (range 34-92). Most participants reported experiencing at least one symptom of pelvic floor dysfunction (76% by Pelvic Floor Distress Inventory-2). The type of treatment had no effect on overall pelvic floor dysfunction on multivariate analysis (all p>0.05). Worse urinary-related symptoms were associated with higher body mass index at surgery (OR 1.41), higher age at time of survey (OR 1.07), and higher numbers of vaginal births (OR 1.43) (all p<0.05). CONCLUSIONS: Overall, pelvic floor dysfunction did not significantly vary by treatment modality. Our findings suggest complex interactions among age, body mass index, and parity as to how uterine cancer treatment affects pelvic floor quality of life, which should be considered in the choice of treatment strategy and patient counseling.

Development of a national minimum data set to monitor deceased organ donation performance in Canada.

PURPOSE: Deceased donation data requires standardization to enable accurate interprovincial and international comparisons of deceased donation performance. In Canada, most provincial organ donation organizations (ODOs) have developed different processes and infrastructures for referring potential donors and subsequent data collection. This has led to differing definitions of the performance measures used for each step in the donation process, from potential donor identification to consent to transplantation. The Deceased Donation Data Working Group (DDDWG), comprised of representatives from ODOs across Canada, was therefore convened by Canadian Blood Services to develop a national, comprehensive, standardized deceased donation minimum data set. METHODS: The DDDWG's scope encompassed considering all potential deceased organ donation data elements, including operational and performance data collected along the deceased donor pathway from donation potential to donation and disposition of organs. An environmental scan was conducted of other existing deceased donation registries from the Canadian and the international community. The DDDWG then engaged in regular face-to-face meetings and teleconferences to develop recommendations for the minimum data set that would satisfy key considerations, including the impact on existing ODO data collection processes, financial impact on stakeholders, the clinical and operational needs of multiple healthcare professionals involved in the deceased donation pathway, and availability of other existing national data sets that could be leveraged to reduce data collection burden. RESULTS: The key deceased donation data elements identified by the DDDWG are contained in an inverted pyramid framework that was derived from similar work conducted in other countries. CONCLUSION: The DDDWG developed recommendations for proposed definitions and data sources that should be adopted nationally to guide the collection of deceased donation data. The ultimate purpose of the final minimum data set is to harmonize and standardize donation data definitions in Canada and align with international standards; inform the development of operational and clinical practice standards at the provincial and national levels; develop a framework for deceased donation performance measures; and advance the science of deceased donation.

RéSUMé: OBJECTIF: Les données concernant les dons d'organes de personnes décédées doivent être normalisées pour permettre des comparaisons précises de l'efficacité de ces dons entre provinces et entre pays. Au Canada, la majorité des organismes provinciaux de dons d'organes (ODO) ont élaboré divers processus et infrastructures pour l'orientation des donneurs potentiels et la collecte subséquente des données. Cela a abouti à des définitions différentes des mesures de performances utilisées pour chaque étape du processus de don, de l'identification du donneur potentiel au consentement à la transplantation. Le Groupe de travail sur les données de donneurs décédés (DDDWG), constitué de représentants des ODO de tout le Canada a donc été réuni par la Société canadienne du sang (SCS) pour élaborer un ensemble national et complet de données minimums standardisées de dons d'organes de personnes décédées. MéTHODES: Le DDDWG avait pour mission d'envisager tous les éléments de données de dons d'organes potentiels de personnes décédées, y compris les données opérationnelles et de performance collectées le long du parcours du donneur décédé, depuis le don potentiel jusqu'à l'utilisation des organes. Une analyse environnementale des autres registres existants (canadiens et internationaux) de dons d'organes de personnes décédées a été effectuée. Le DDDWG a alors entrepris des entretiens en face à face et des téléconférences pour élaborer ses recommandations pour un ensemble minimum de données qui répondraient aux problèmes clés, y compris : leur impact sur les processus de collecte de données des ODO existants, l'impact financier pour les différents acteurs, les besoins cliniques et opérationnels des multiples professionnels de santé impliqués tout au long du parcours de don de la personne décédée, et la disponibilité d'autres ensembles de données qui pourraient être utilisés pour réduire le fardeau de la collecte des données. RéSULTATS: Les principales données de don d'organes de donneur décédé, identifiées par le DDDWG, tiennent dans un cadre en pyramide inversée tiré d'un travail semblable mené dans d'autres pays. CONCLUSION: Le DDDWG a élaboré des recommandations pour les définitions proposées et les sources de données qui devraient être adoptées à l'échelon national pour guider la collecte des données de dons d'organes de personnes décédées. Le but ultime de l'ensemble minimum final de données est d'harmoniser et standardiser les définitions des données concernant les dons au Canada et de s'aligner sur les normes internationales; d'informer le développement de normes opérationnelles et de pratique clinique au niveau des provinces et au niveau national; de développer un cadre pour la mesure des performances concernant les dons de donneurs décédés; et de faire progresser les connaissances sur ce type de dons.

Increasing Rates of Kidney Failure Care in Canada Strains Demand for Kidney Donors.

The number of patients with kidney failure is on the rise in Canada, leading to a higher need for dialysis treatment and greater demand for kidney transplants, which have superior patient outcomes and lower healthcare system costs than dialysis treatments. This study examines the incidence and prevalence of kidney failure and renal replacement therapies between 2005 and 2014. The number of patients on dialysis has increased by 31% over this decade. The number of annual kidney transplants performed has also increased along with the waiting list for a kidney transplant, resulting in a persistent 2.5 times gap between patients on a waiting list for a kidney and the number of kidney transplants performed. New programs to increase organ donation to kidney failure patients have led to improvements, but have not been able to close this gap. Continued innovations are needed to preserve kidney function for patients with chronic kidney disease and to promote and increase donation rates in Canada to improve the quality of life and survival of thousands of patients, as well as save hundreds of millions of dollars to healthcare systems in Canada.

Comparing long-term sexual dysfunction across different uterine cancer treatment modalities.

INTRODUCTION: The objective of this study was to assess differences in long-term sexual and menopausal side effects after uterine cancer treatment among treatment modalities. METHODS AND MATERIALS: This is a cross-sectional study that examined women treated for uterine cancer from 2006-2018. Eligible women included those who underwent a hysterectomy/bilateral salpino-oophorectemy alone (HS), with brachytherapy (BT), or with external beam radiation therapy (EBRT). A noncancer cohort of women who underwent a hysterectomy/BSO for benign indications were also identified (non-CA). To compare outcomes, we utilized a shortened form of the female sexual function index (FSFI) and the menopause survey, which consists of 3 subscales: hot flashes, vaginal symptoms, and urinary symptoms. Demographic, comorbidity, and other treatment variables were collected. Survey totals were compared across cohorts using ANOVA tests and logistic regression. RESULTS: A total of 284 women completed the Menopause Survey (Non-CA 64, HS 60, BT 69, EBRT 91); 116 women reported sexual activity in the last 4 weeks and completed the FSFI (NC 32, HS 21, BT 31, EBRT 32). The mean FSFI score for the entire cohort was 11.4 (SD 4.16), which indicates poor sexual function. There was no significant difference between any cohort in the overall FSFI score (p = 0.708) or in any of the FSFI subscales (all p > 0.05). On univariate analysis, BT was associated with fewer menopausal hot flashes and vaginal symptoms compared to the non-CA cohort (p < 0.05), which did not persist on multivariable analysis. CONCLUSION: There was no significant difference in sexual dysfunction or menopausal symptoms in those treated for uterine cancer with or without adjuvant radiation. Most patients reported poor sexual function.

Building Capacity for Cancer Research in the Era of COVID-19: Implementation and Results From an International Virtual Clinical Research Training Program in Zambia.

PURPOSE: The incidence of cancer in sub-Saharan Africa is increasing rapidly, yet cancer research in the region continues to lag. One contributing factor is limited exposure to clinical research among trainees. We describe implementation and results of a virtual clinical research training program for Zambian clinical oncology fellows developed jointly by the Cancer Diseases Hospital in Zambia and the MD Anderson Cancer Center to address this need. METHODS: The clinical research training program consisted of 14 weekly virtual lectures, development of research questions by Zambian clinical oncology fellows, assignment of faculty and peer mentors, longitudinal mentorship of research protocols, and anonymous precourse and postcourse surveys. The paired t-test was used to analyze the change in academic self-efficacy scores. RESULTS: Fourteen Zambian clinical oncology fellows participated. Senior fellows were paired with research mentors, leading to the development of eight research protocols. A total of 70 meetings and 126 hours of mentorship occurred with a median of seven meetings and 15 hours per pairing. The precourse and postcourse survey response rates were 86% and 79%, respectively. There were statistically significant increases in nine of 12 academic self-efficacy domains. The largest gains were in ability to independently perform research (P < .001) and research mentorship (P = .02) with an average increase of 1.5 points on a five-point scale in both domains. CONCLUSION: The Cancer Diseases Hospital MD Anderson Cancer Center clinical research training program for Zambian clinical oncology fellows led to increases in multiple academic self-efficacy domains among participants, formation of longitudinal mentorship groups with both faculty and peer mentors, and development of Zambian-led research protocols, demonstrating the feasibility of implementing a virtual model. This may be especially relevant because of shifting international collaboration paradigms after the COVID-19 pandemic.

Use of Specific Duodenal Dose Constraints During Treatment Planning Reduces Toxicity After Definitive Paraaortic Radiation Therapy for Cervical Cancer.

PURPOSE: This study aimed to validate the safety of paraaortic nodal (PAN) radiation therapy (RT) for patients with cervical cancer when the duodenal dose is limited to V55 < 15 cm3 and V60 < 2 cm3. METHODS AND MATERIALS: A total of 97 patients who were treated with RT for cervical cancer between 2010 and 2018 received at least 56 Gy to grossly involved PANs. Patients were treated with concurrent chemoradiation (n = 88; 91%), with 93% of patients (n = 90) receiving intensity modulated RT to the initial PAN field and 98% (n = 95) receiving intensity modulated RT to a sequential PAN boost. The V55 < 15 cm3 and V60 <2 cm3 criteria were implemented in 2014. Normal tissues were contoured on computed tomography (CT) simulation data sets, and the duodenum was contoured from the gastric outlet to the duodenojejunal flexure. Sixty-six patients (68%) had a resimulation scan after approximately 20 fractions. Composite duodenal doses were calculated using the initial CT scan for 50 patients (52%) and the resimulation CT scan for 47 patients (48%) depending on the anatomic changes throughout treatment. RESULTS: The median duodenal V55 was 3.5 cm3 (interquartile range [IQR], 0.2-8.1 cm3) and the median V60 was 0.3 cm3 (IQR, 0.0-1.8). Constraints were exceeded in 18 patients, of whom 16 patients (89%) had been treated before 2014. Treatment for the 2 patients treated after 2014 was complicated by significant weight loss and reduced anterior-posterior diameter, which likely overestimated the true dose on the composite plan. Only 1 patient experienced grade 3 duodenal toxicity (stricture requiring endoscopic balloon dilation 3 months after treatment); however, the stricture was outside of the high-dose boost volume, and the patient had a history of gastritis. Six patients (6%) had a first recurrence within the PAN region. CONCLUSIONS: Limiting the duodenal dose to V55 < 15 cm3 and V60 < 2 cm3 for patients with cervical cancer and PAN involvement is feasible, and minimizes duodenal toxicity while maintaining acceptable local control rates.

Longitudinal Changes in Bone Mineral Measurements Inside and Outside Radiation Fields Used for Cervical Cancer Treatment.

PURPOSE: We compared the magnitude of changes in bone mineral density (BMD), within and outside the radiation field, among women who received pelvic radiation therapy (RT) with or without chemotherapy for cervical cancer. METHODS AND MATERIALS: In this secondary analysis of a prospective study, we analyzed serial computed tomography scans and dual-energy x-ray absorptiometry scans from 78 patients who received definitive RT or chemoradiation therapy (CRT) for cervical cancer at a single institution from 2008 to 2015. BMD values at L1, L2, L3, and L4 were measured. We compared changes in BMD within the radiation field (ie, at L4) with those outside the field (ie, at L1). Linear mixed models were also used to examine the effect of RT on changes in BMD over time and covariate adjustment. RESULTS: The median age of the 78 patients was 45.5 years (range, 23-88 years); all received RT and 76 (97%) received concurrent CRT. Treatment was associated with significant declines in BMD in all 4 lumbar vertebral bodies over time (P < .05), with nadir at 3 months for L4 and at 1 year for L1. Pairwise comparisons at 3 months and 2 years after treatment indicated that BMD in L4 (within the RT field) had improved (P = .037), but BMD in L1 (outside the RT field) was no different at 3 months and 2 years. CONCLUSIONS: Significant BMD declines were observed in all lumbar vertebral bodies immediately after RT. However, in-field vertebral bodies reached nadir BMD earlier than those located outside the RT field. Our results suggest that treatment and patient-related factors other than RT may contribute to declines in BMD after treatment for cervical cancer. Routine bone density screening and post-RT therapy with hormones may be beneficial for selected patients who receive CRT for cervical cancer.

Immune correlates of therapy outcomes in women with cervical cancer treated with chemoradiotherapy: A systematic review.

BACKGROUND: Immune markers have been correlated with prognosis in a variety of solid tumors, including cervical cancer. OBJECTIVE: To review the literature on hematologic and immune markers and their association with recurrence and survival among patients with cervical cancer treated with chemoradiation. EVIDENCE REVIEW: This systematic review was conducted in accordance with PRISMA guidelines via searches of Ovid MEDLINE, Ovid Embase, and the Cochrane Library using keywords regarding cervical cancer, immune markers, and HIV. Studies involving patients treated with cisplatin-based chemoradiotherapy were selected and reviewed by at least two independent reviewers, with disagreements resolved by a third reviewer. FINDINGS: A total of 737 studies were identified, of which 314 assessed immune biomarkers in immunocompetent patients (30 included in the final analysis) and 327 studies in immunosuppressed patients (5 included in the final analysis). The strongest prognostic indicators were lymphopenia and elevated neutrophil-to-lymphocyte ratio. Other potential markers included HPV-specific lymphocyte response, cytokine profile, expression of immune-blocking antigens on cell surfaces, and tumor-associated lymphocyte, macrophage, and neutrophil infiltration. Studies of immunosuppressed patients described more severe cytopenic changes overall and concluded that viral suppression led to improved outcomes. CONCLUSIONS: The immunologic interplay at work in cervical cancer development, progression, and treatment is complex. Strong evidence was found in favor of lymphopenia and elevated neutrophil-to-lymphocyte ratio being prognostic for worse outcomes with other markers showing potential associations as well. Although the interpretation of immune status with regard to treatment approach remains unclear, future studies should aim to tailor treatment that minimizes possible detrimental immune effects.

The SPOR-Canadian Data Platform: a national initiative to facilitate data rich multi-jurisdictional research.

Administrative health data is recognized for its value for conducting population-based research that has contributed to numerous improvements in health. In Canada, each province and territory is responsible for administering its own publicly funded health care program, which has resulted in multiple sets of administrative health data. Challenges to using these data within each of these jurisdictions have been identified, which are further amplified when the research involves more than one jurisdiction. The benefits to conducting multi-jurisdictional studies has been recognized by the Canadian Institutes of Health Research (CIHR), which issued a call in 2017 for proposals that address the challenges. The grant led to the creation of Health Data Research Network Canada (HDRN), with a vision is to establish a distributed network that facilitates and accelerates multi-jurisdictional research in Canada. HDRN received funding for seven years that will be used to support the objectives and activities of an initiative called the Strategy for Patient-Oriented Research Canadian Data Platform (SPOR-CDP). In this paper, we describe the challenges that researchers face while using, or considering using, administrative health data to conduct multi-jurisdictional research and the various ways that the SPOR-CDP will attempt to address them. Our objective is to assist other groups facing similar challenges associated with undertaking multi-jurisdictional research.

Chronic pain and analgesic use in CKD: implications for patient safety.

BACKGROUND AND OBJECTIVES: Chronic pain in predialysis CKD is not fully understood. This study examined chronic pain in CKD and its relationship with analgesic usage. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data include baseline visits from 308 patients with CKD enrolled between 2011 and 2013 in the Safe Kidney Care cohort study in Baltimore, Maryland. The Wong-Baker FACES Pain Rating Scale measured chronic pain severity. Analgesic prescriptions and over-the-counter purchases were recorded up to 30 days before visits, and were classified as a drug-related problem (DRP) based on an analgesic's nephrotoxicity and dose appropriateness at participants' eGFR. Participants were sorted by pain frequency and severity and categorized into ordinal groups. Analgesic use and the rate of analgesics with a DRP were reported across pain groups. Multivariate regression determined the factors associated with chronic pain and assessed the relationship between chronic pain and analgesic usage. RESULTS: There were 187 (60.7%) participants who reported chronic pain. Factors associated with pain severity included arthritis, taking ≥12 medications, and lower physical function. Use of nonsteroidal anti-inflammatory drugs was reported by seven participants (5.8%) with no chronic pain. Mild and severe chronic pain were associated with analgesics with a DRP, with odds ratios of 3.04 (95% confidence interval [95% CI], 1.12 to 8.29) and 5.46 (95% CI, 1.85 to 16.10), respectively. The adjusted rate of analgesics with a DRP per participant increased from the group with none to severe chronic pain, with rates of 0.07 (95% CI, 0.04 to 0.13), 0.12 (95% CI, 0.07 to 0.20) and 0.16 (95% CI, 0.09 to 0.27), respectively. CONCLUSIONS: Chronic pain is common in CKD with a significant relationship between the severity of pain and both proper and improper analgesic usage. Screening for chronic pain may help in understanding the role of DRPs in the delivery of safe CKD care.

Canadian Organ Replacement Register (CORR): reflecting the past and embracing the future.

INTRODUCTION: The Canadian Organ Replacement Register (CORR) is the only Canadian information system on kidney and extra-kidney organ failure and transplantation in Canada. CORR's mandate is to record and analyze the level of activity and outcomes of vital organ transplantation and treatment of end stage kidney disease using dialysis, either hemodialysis or peritoneal dialysis, activities across Canada. The Canadian Organ Replacement Register was officially launched in 1987, and it included transplantation of extra-renal vital organs (liver, heart, lung, pancreas, bowel), in addition to renal transplantation and replacement therapy, with new financial support from the provinces. OBJECTIVE: This manuscript describes the process of data acquisition and reporting, focusing on the patients with end stage kidney disease on dialysis, with data reported from the 2014 CORR Annual Data Report and the Center-Specific Reports on Clinical Measures. METHODS: CORR is currently housed in the Canadian Institute for Health Information and collects data from hospital dialysis programs, regional transplant programs, organ procurement organizations and kidney dialysis services offered at independent health facilities. Data on patients is collected by completion of survey forms for each patient at the start of dialysis or receiving a transplant, using the Initial Registration form, and yearly follow up forms, which collects data on the status of the patient as of October 31(st). RESULTS: The incident rate per million population (RPMP) has remained stable with the exception of the 65+ age group with has experience a modest decrease since 2001. However, there has been an increasing prevalence of ESKD diagnoses, with the highest rate per million population (RPMP) amongst the age group 65+ years. This is likely attributed to gradual improving patient survival. Between 2003 and 2012, nearly 90% of dialysis patients younger than <18 and 26% of patients 75+ years survived for at least five years. CONCLUSION: As the number of people treated for end-stage organ failure grows, so does the importance of understanding their treatment and outcomes. In 2014, CORR continues to evolve and support the important information need to advance ESRD research and clinical practice.

INTRODUCTION: Le Registre canadien des insuffisances et des transplantations d'organes (RCITO) est le seul réseau d'information sur l'insuffisance rénale et extrarénale et la transplantation au Canada. Le mandat du RCITO est de rapporter et d'analyser le niveau d'activité et les résultats des transplantations d'organes vitaux, de même que le traitement de l'insuffisance rénale terminale (IRT) par la dialyse, sous forme d'hémodialyse ou de dialyse péritonéale, au Canada. Le registre a officiellement été lancé en 1987, et il comprenait la transplantation d'organes vitaux extrarénaux (foie, cœur, poumon, pancréas, intestin), en plus de la transplantation rénale et de la thérapie de remplacement rénal, grâce à un financement nouveau des provinces. OBJECTIFS: Le présent manuscrit décrit le processus d'acquisition et de communication des données sur les patients au stade d'insuffisance rénale terminale qui ont une thérapie de remplacement rénal, et des données tirées du rapport annuel de 2014 du RCITO et de rapports concernant les centres au sujet des mesures cliniques. MÉTHODES: Le RCITO est actuellement hébergé par l'Institut canadien d'information sur la santé et recueille des données au sujet des programmes de dialyse en milieu hospitalier, des programmes régionaux de transplantation, des services de prélèvement d'organes et des services de dialyse rénale offerts dans des établissements de santé indépendants. Les données sur les patients sont recueillies par le truchement d'un sondage mené auprès de chaque patient au début de la dialyse ou avant une transplantation, grâce au formulaire d'enregistrement et aux formulaires de suivi annuels, qui recueillent des données sur le statut du patient en date du 31 Octobre. RÉSULTATS: Le taux d'incidence par million de population est demeuré stable, à l'exception de la tranche d'âge des 65 ans et plus, qui a subi une faible diminution depuis 2001. Toutefois, il y a eu prévalence accrue des diagnostics d'IRT, avec le taux le plus élevé par million de population chez les 65 ans et plus. Ceci est probablement attribuable à l'amélioration graduelle de la survie des patients. Entre 2003 et 2012, près de 90% des patients en dialyse âgés de moins de 18 ans et 26% des patients de plus de 75 ans ont survécu pendant au moins 5 ans. CONCLUSION: L'importance de comprendre les traitements appropriés et les résultats croît à mesure qu'augmente le nombre de personnes traitées pour insuffisance d'organe. En 2014, le RCITO continue d'évoluer et de soutenir les besoins considérables en information afin de faire avancer la recherche et la pratique clinique en IRT.

Organ donation and transplantation in Canada: insights from the Canadian Organ Replacement Register.

PURPOSE OF REVIEW: To provide an overview of the transplant component of the Canadian Organ Replacement Register (CORR). FINDINGS: CORR is the national registry of organ failure in Canada. It has existed in some form since 1972 and currently houses data on patients with end-stage renal disease and solid organ transplants (kidney and/or non-kidney). The transplant component of CORR receives data on a voluntary basis from individual transplant centres and organ procurement organizations across the country. Coverage for transplant procedures is comprehensive and complete. Long-term outcomes are tracked based on follow-up reports from participating transplant centres. The longitudinal nature of CORR provides an opportunity to observe the trajectory of a patient's journey with organ failure over their life span. Research studies conducted using CORR data inform both practitioners and health policy makers alike. IMPLICATIONS: The importance of registry data in monitoring and improving care for Canadian transplant candidates/recipients cannot be over-stated. This paper provides an overview of the transplant data in CORR including its history, data considerations, recent findings, new initiatives, and future directions.

BUT DE LA REVUE: Offrir un aperçu du volet « transplantation d'organes ¼ du Registre canadien des insuffisances et des transplantations d'organes (RCITO). RÉSULTATS: Le RCITO est le Registre canadien des insuffisances d'organes au Canada. Il a commencé à prendre forme en 1972, et contient à l'heure actuelle des données sur des patients atteints de néphropathie terminale et sur des transplantations (rénales ou non rénales) d'organes pleins. Le volet « transplantation d'organes ¼ du RCITO collige des données qui ont été envoyées, sur une base volontaire, par des centres de transplantation et des services d'approvisionnement en organes à travers le pays. Le Registre offre une couverture exhaustive et complète des différentes interventions de transplantation. Les résultats à long terme sont retracés à partir de rapports de rendez-vous de suivi des centres de transplantation participants. L'ampleur longitudinale du RCITO offre la possibilité d'observer le parcours, tout au long de sa vie, du patient atteint d'une insuffisance organique. Les études produites à partir des données du RCITO éclairent à la fois les praticiens et les décideurs du domaine de la santé. IMPLICATIONS: On ne peut surestimer l'importance des données du Registre lorsqu'il s'agit d'effectuer le suivi des candidats canadiens potentiels à une transplantation, ou d'améliorer les soins qui leur sont offerts. Cette revue offre un aperçu des données du RCITO qui se rapportent à la transplantation d'organes, dont : l'historique, les éléments à considérer sur les données, des résultats récents, de nouvelles initiatives et les orientations futures.