Transplant Evidence

May 2012 Transplant Trial Watch now online

Simon Knight — Wed, 01 May 2013 19:16:23 +0000

The May 2013 edition of the Transplant Trial watch is now available on the CET website and our Trial Watch app for iPhone, iPad and Android.

This month, trials include long-term follow-up of steroid avoidance in liver transplantation, the eternal question of T-tubes following liver transplant and mizoribine in renal transplantation.

Boston researchers create bioengineered kidney

Simon Knight — Wed, 17 Apr 2013 08:16:25 +0000

Researchers in Boston, Massachusetts have published the first description of successful transplantation of a bioengineered kidney into rats. The paper, published in this week’s Nature Medicine describes the process of decellularization by detergent perfusion and regeneration with epithelial and endothelial cells. The resulting kidney was capable of filtering and producing urine both in vitro and in vivo, although the ability to concentrate urine was considerably reduced compared to that in cadaveric controls.

These initial results of the technique are very encouraging, and refinement could lead to the development of a functional bioengineered kidney. Such a development would reduce the waiting list burden for cadaveric kidneys and potentially obviate the need for immunosuppression.

What trials in transplantation would you like to see?

Simon Knight — Wed, 03 Apr 2013 09:16:49 +0000

Peter Morris gave the following presentation at this year’s British Transplant Society Congress after polling members as to what trials they would like to see performed in the field of transplantation in the near future. There are many interesting ideas to help guide future research projects. If you have any further ideas, please let us know in the comments below!

Trials I would like to see in transplantation from transplantev

Exclusion of elderly patients in clinical trials

Simon Knight — Tue, 02 Apr 2013 18:17:27 +0000

There is an interesting editorial in this month’s Transplantation discussing the exclusion of elderly patients from clinical trials. Such practice clearly has an impact on the generalisability of the results of trials to an increasingly ageing transplant population (the proportion of US kidney transplant recipients aged 65 or over doubled from 7% to 16% between 1999 and 2008). In trials of immunosuppression, it is equally important to document differences in absorption and metabolism in elderly patients that may affect dosing in this important group.

The article highlights current FDA guidance on enrolment of elderly patients to clinical trials, and is well worth a read.

April 2013 Transplant Trial Watch now online

Simon Knight — Thu, 28 Mar 2013 15:52:30 +0000

The April 2013 edition of the Transplant Trial Watch is now available on the CET website. Each month, CET staff select 10 important RCTs in the field of transplantation, summarise the findings and assess trial quality.

This month, trials include vildagliptin and pioglitazone for post-transplant glucose intolerance, sirolimus in transplant patients with squamous cell carcinoma and harmonic scalpel use in IVC-preserving recipient hepatectomy.

Surgical Ethics

Peter Morris — Fri, 01 Mar 2013 18:07:17 +0000

This editorial by Professor Daniel Sokol on Surgical Ethics is well worth noting. Professor Sokol is a Barrister and also a Senior Lecturer in Medical Ethics at Imperial College. He has written a very perceptive editorial on this subject which is entirely relevant to transplant surgeons. But he also makes the point that the pamphlet produced by The Royal College of Surgeons of England entitled “Good Surgical Practice” should be read by every surgeon, and reread once a year!

Improving outcomes of living donor right hepatectomy

Peter Morris — Fri, 01 Mar 2013 18:05:11 +0000

This article is a single centre review from the National Liver Cancer Centre in Korea of their experience of living donor right hepatectomy between 2005 and 2011 and includes 300 consecutive living donors. The authors examine the data in three cohorts of 100 donors. The overall complication rate was 16% and there were no deaths. However in the last cohort of 100 donors the complication rate was just 3%. This experience from Korea is quite remarkable and I thought worth a note, although not a randomised trial!

Transplantation at a glance

Peter Morris — Fri, 01 Mar 2013 18:01:06 +0000

I have just looked at this small book by Menna Clatworthy, Chris Watson, Michael Allison and John Dark and was most impressed. It provides a comprehensive coverage of all aspects of organ transplantation at a level that all, with some medical background, would understand. It is beautifully illustrated and at only around 100 pages it provides a marvellous initial introduction to people involved with transplantation on the edge so to speak, such as scientists doing some work with transplantation, residents and house officers rotating through transplantation programmes and nursing staff on the transplant ward. It is highly recommended.

The book is also available as an electronic issue.

March 2013 Transplant Trial Watch now online

Simon Knight — Thu, 28 Feb 2013 18:28:38 +0000

The March 2013 edition of the Transplant Trial Watch is now available on the CET site and via our app for iPhone, iPad and Android.

This month, trials include epidural anaesthesia in renal transplantation, pharmacodynamic monitoring of tofacitinib and the association between inflammatory markers and response to CMV treatment.

Evidence in Transplantation Course (EVIT 5)

Peter Morris — Thu, 28 Feb 2013 15:41:35 +0000

The 5th EVIT course sponsored by ESOT has just been held at the Royal College of Surgeons of England over an intense 2 days. The faculty was made up of members of the CET and the CEU of the College and the London School of Hygiene and Tropical Medicine. There was an enthusiastic group of participants ranging from a PhD student to a consultant transplant surgeon, most being trainees. The course covered a range of relevant topics in the evaluation of evidence ranging from searching the literature to the conduct of a systematic review. Finally the participants were split into two groups and each prepared a systematc review of Prograf versus Advagraf with Forest plots, which was presented by a spokesman for each group in the final session. Even the faculty were impressed!