The CET was established at the beginning of 2005 by Professor Sir Peter Morris with the aim of providing a source of high quality evidence based information on all aspects of solid organ transplantation. It is situated within the Clinical Effectiveness Unit (CEU) of The Royal College of Surgeons of England and both it and the CEU are a joint department of The Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine of the University of London, the major institute of public health in the UK. The CEU staff includes epidemiologists, medical statisticians, information specialists and surgical research fellows and is predominantly involved in evaluating the outcomes of surgical procedures and the development of guidelines, but is also responsible for the audit of all liver and cardiothoracic transplantation in the United Kingdom.
We now have an annex in Oxford in space generously provided by Professor Dame Valerie Beral in the Cancer Epidemiology Unit on the 3rd floor of the Richard Doll building on the Oxford University Campus at the Churchill Hospital.
The CET has been involved in a number of projects since its establishment, one of which has been to establish a registry of all randomised controlled trials in organ transplantation and to evaluate the methodological quality of those trials since January 2004. This registry was published as a regular feature in the journal Transplantation, but from January 2008 this has been replaced by the Transplant Library. The Transplant Library is an electronic library of all RCTs in solid organ transplantation from 1970 to the present and more recently includes systematic reviews that are regarded as of reasonable quality. The development of an electronic library has been a major project and includes all randomised controlled trials in solid organ transplantation. This is a joint project between the CET and publisher Lippincott, Williams & Wilkins. The library went live to subscribers of the journal Transplantation at end of January 2008. From March 2009 it became available to all members of the European Society of Transplantation, and is also available in many libraries and medical schools.
The Centre has also carried out and is carrying out a number of systematic reviews such as the role of C2 monitoring of cyclosporine in determining clinical outcomes, the evaluation of calcineurin sparing or calcineurin free protocols and clinical outcomes, the role of liver transplantation in the management of hepatic malignancy, an evaluation of mycophenolate mofetil and azathioprine and clinical outcomes and the role of prophylaxis for TB.
In an analysis of the methodology of randomised controlled trials in organ transplantation between 2004 and 2006 it was found that only around one third of those trials were methodologically sound in their design. A smaller sample of 91 RCT's published in 2004 was evaluated for the quality of reporting of outcomes of RCT’s and again we found significant defects in a majority of trials.
On the basis of this information an agreement has been reached with ESOT that the CET would become the Knowledge Centre for ESOT and would offer advice in the design of RCTs, as well as provide assistance with the reporting of RCTs. Trials that were methodologically sound in design would be given ESOT/CET accreditation.
A Scientific Advisory Board is now in place. The members are Professor Andrew Bradley, Professor Colin Baigent, Professor John Forsythe, Professor Peter Friend, Professor Rutger Ploeg, Professor Jan van der Meulen and Professor Chris Watson.