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ESOT: streamlining transplant activities in Europe

European Society of Organ Transplantation
W: www.esot.org

The European Society for Organ Transplantation (ESOT) is an umbrella organisation under which all European transplant activities are organised. Founded in 1992, there are currently just over 1,000 members of ESOT. ESOT cooperates with many transplant organisations to provide a structure and to streamline these transplant activities in Europe.

Structure
The Society is made up of a council, general assembly, organ expert groups and committees. There are currently three organ expert groups:

  • ELITA, which focuses on the liver and intestines.
  • EPITA, which focuses on the pancreas and islets.
  • The thoracic committee in conjunction with the ESHLT, which focuses on the heart and lungs.

In addition to these groups there are the committees. Currently there are four committees: the Ambassador Committee, the Basic Science Committee, the Education Committee and the European Donation Committee.

Education
One of ESOT’s main goals is to educate professionals in the field of transplantation. In the past few years, ESOT has launched an impressive educational package that now contains eight different high-level courses. From a basic introduction to transplantation for young clinicians and scientists with the Hesperis Course, to highly specialised masterclasses focusing on donor surgery (EDSM), transplant surgery (TOP course) or lab skills, ESOT tries to offer a complete transplant education. The courses aim not only to extend knowledge and feed discussions but also to encourage the development of a European transplant network.

ESOT has also introduced a new grant programme, structured in collaboration with the Basic Science Committee and the Grant Committee, and aims to support both fundamental/experimental and translational/clinically applied research. A number of grants include travel, to help European individuals acquire skills, techniques and knowledge by visiting or working with colleagues in other, preferably European but sometimes further afield transplant centres or institutions. In this respect, ESOT wants to increase the learning curve of the individual recipient of a grant. At the same time, this experience may enhance the development of transplantation in the home institution when the candidate returns.

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ESOT Annual Congress
Every two years ESOT holds its congress in a European city. Many professionals in the field of transplantation convene to share the latest results of various aspects of transplantation research. The most recent took place in Prague from 28 September to 3 October and played host to a record-breaking 3,500 delegates.

Centre for Evidence in Transplantation
A relatively recent development for the ESOT is the Centre for Evidence in Transplantation (CET), 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. 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 transplantations in the UK.

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 control trials (RCTs) in organ transplantation and to evaluate the methodological quality of those trials since January 2004. This registry has been published as a regular feature in the journal Transplantation, but from January 2008 this will be replaced by an electronic library of all RCTs, and it is also planned to include systematic reviews that are regarded as of reasonable quality. The centre has also carried out and is carrying out a number of systematic reviews such as the role of C2 monitoring of ciclosporin 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, and an evaluation of mycophenolate mofetil and azathioprine and clinical outcomes.

In a preliminary analysis of the methodology of RCTs in organ transplantation it was found that, in the year 2004, 91 RCTs were published in the literature but only around one-third of those trials were methodologically sound in their design. A smaller sample was evaluated for the quality of reporting of outcomes of RCTs, and again significant defects were found in a majority of trials.

On the basis of this information an agreement has been reached that the CET would become the knowledge centre for the ESOT, offering advice in the design of RCTs as well as providing assistance with the reporting of RCTs. Trials that are methodologically sound in design will be given ESOT/CET accreditation.

For further information on the ESOT and its activities, visit www.esot.org

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