October 2015 Transplant Trial Watch now available

Posted by Simon Knight on October 2, 2015

The October 2015 edition of the Transplant Trial watch is now available online and via the Trial Watch app.

This month, new studies include long-term outcomes of sirolimus-based immunosuppression in renal transplant recipients, remote ischaemic preconditioning and therapeutic hypothermia in organ donors.

Evidence-based guidelines now available in the Transplant Library

Posted by Simon Knight on September 22, 2015

We are pleased to announce that we have now included evidence-based guidelines relevant to solid organ transplantation in the Transplant Library. This means that you can now find all RCTs, systematic reviews and guidelines in the field in one place!

For more information about the guidelines included, please visit our guidelines page.

The guidelines are available via the Transplant Library on the Evidentia platform – to find out how to get access, please click here.

September 2015 Transplant Trial Watch now available

Posted by Simon Knight on September 7, 2015

The September 2015 edition of the transplant trial watch is now available on the CET site, and via our mobile app.

Sir Peter Morris introduces the Transplant Library – Video

Posted by Simon Knight on August 12, 2015

In this video recorded for the Texas Transplantation Society, Sir Peter Morris introduces the Transplant Library and it’s potential benefits to their members.

July 2015 Transplant Trial Watch now online

Posted by Simon Knight on July 2, 2015

The July edition of the transplant trial watch is now available on our website and via the app for iPhone, iPad and Android.

This months trials include computer-guided tacrolimus dosing, radial versus femoral cannulation for cardiac transplantation and Sorafenib in liver transplant candidates with HCC.

Outcomes after bilateral hand allotransplantation: a risk/benefit ration analysis

Posted by Peter Morris on June 22, 2015

This is an interesting long term report of five patients who had bilateral hand allotransplants performed in the Lyon centre some years ago with a follow up ranging from three to 13 years. There were four men and one woman and all were young and the level of amputation was distal in three cases and mid forearm level in two patients. Patients essentially had the same immunosuppressive therapy with thymoglobulin induction and then tacrolimus, MMF and prednisone. Patient and graft survival was 100% and all recipients showed reasonable sensory motor recovery and partial recovery of intrinsic muscles in the hand and were able to perform a majority of activities of daily living. Most complications occurred in the first year after transplantation and all patients experienced at least one episode of acute rejection which was easily reversed with high dose steroids. One patient had six episodes of acute rejection. The risks associated with long term immunosuppression were studied and certainly appeared to be acceptable. The patients themselves found that the outcome was acceptable both socially and functionally. Regular angiograms failed to show any evidence of vasculopathy but the authors point out that this remains a continuing risk. This is in contrast to another study where evidence of vasculopathy was found. But the use of continuing triple therapy may have prevented the development of vasculopathy. This is an important long term follow up and as time goes by, far more information will be available about the long term function of hand transplants.

Transplant Library promoted at the Texas Transplantation Society meeting

Posted by Liset Pengel on June 18, 2015

The Texas Transplantation Society is the first US society to provide access to the Transplant Library database for all its members. The Transplant Library will be introduced by Sir Peter Morris by video and by Mr Mark Schregardus, CEO of Evidentia Publishing during 28th Annual Scientific Meeting of the Texas Transplantation Society, July 23-26, 2015, Austin, Texas.

HIV Positive to HIV positive kidney transplantation- results at 3-5 years

Posted by Peter Morris on June 12, 2015

Although the outcome of kidney transplantation in HIV positive patients who receive organs from HIV negative donors has been reported as being similar to the outcome in HIV negative recipients, this report from South Africa is the first long term follow up of HIV positive patients who receive kidneys from HIV positive deceased donors.

Over a six year period, 27 HIV positive patients underwent kidney transplantation from deceased donors who tested positive for HIV. All the recipients were HIV positive but were receiving antiretroviral therapy. Survivors were followed for a median of 2.4 years and patient survival was 84% at one year, 74% at five years. Graft survival after censoring for death was 93% and 84% respectively. Thus it is does seem that HIV positive recipients can be transplanted safely with a kidney from a HIV positive donor, which does provide an additional approach to renal replacement therapy in these patients.

Death of David Sackett

Posted by Peter Morris on June 12, 2015

I was sad to hear that David Sackett died recently at the age of 80. He was arguably the father of evidence based medicine and the first chair of the Cochrane Collaboration steering group in 1993. He was appointed the first Professor of the newly founded Oxford Centre for Evidence Based Medicine in 1994, having come from the Department of Clinical Epidemiology and Biostatistics at McMaster University Department, which he founded in 1967. David was a delightful person whom I got to know well during his time in Oxford and there was no question that he changed the whole approach to the evaluation of evidence in medicine in Oxford. Many young clinicians adopted his approach to this new field, which he had made his own, and Evidence Based Medicine has now become almost an industry.

His contributions to medicine were enormous and he will be missed by all, but certainly never forgotten.

Deviation from intention-to-treat analysis alters treatment effect

Posted by John O'Callaghan on June 12, 2015

A recent article in the BMJ by Abraha et al, using large amounts of data from RCTs, has shown that deviation from intention-to-treat analysis (ITT) can lead to apparently larger treatment effects. When compared to standard intention-to-treat analysis there was a significant difference in the apparent treatment effect. When a deviation from ITT was compared to no ITT, there was no significant difference.

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