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The new face of organ transplantation

Bernard Charpentier
European Society of Organ Transplantation

Transplantation is one of the best examples of basic and clinical investigations developing at the same time. Since the pioneering works of the early 1950s, transplantation now touches many different fields of research. It seems, however, that much of this research has been going round in circles for some time. Developing new areas of research, such as emerging technologies, stem cells, in- vitro embryogenesis and the interface between physics and biology, would be beneficial to the whole transplantation community.

Major advances
This fact was illustrated during the past 12 months through articles in the journal Transplant International and conference papers, such as those at the 12th Congress of the European Society for Organ Transplantation (ESOT) in Geneva. Major advances have been made in the basic aspect of tolerance and clinical trials of tolerance induction, T-cell regulation and immune deviation. A major role has been defined for FOX P3 gene polymorphism,cytokine polymorphism, the CD25+ FOX P3+ regulatory cells in transplantation tolerance and ex-vivo gene therapy.
Stem cells are a particular area of interest currently, with progress being made in the transplantation of embryonic organs, stem cell transplantation for cardiac regeneration, liver regeneration with mesenchymal stem cells and stem cells for pancreatic islet generation. However, major advances have been made in the clinical aspects of transplantation, such as HIV and organ transplantation, high-risk donors, split liver and surgical techniques of liver transplantation, rituximab and acute vascular rejection, limb transplantation, microsurgical bench arterial reconstruction and laparoscopic live donor nephrectomy.

Finally, emerging technologies will ensure new approaches to, for example, the treatment of diabetes and alternatives to whole pancreas transplantation. Major advances have also been seen in the xenotransplantation of pig islets, the bioartificial endocrine pancreas and porcine islet cells microencapsulation.

ESOT was founded in 1982 and today has more than 1,000 transplant professionals dedicated to patient care, clinical and basic research, and clinical and basic education in the field of transplantation. ESOT is designed as a forum for knowledge exchange in the field of transplantation between European transplant physicians, surgeons, biologists and scientists. As a major society that encourages “science”, the ESOT biannual congress and Transplant International will be open to new areas of research mentioned above and a forum for all the basic science and clinical investigations around the world.

ESOT also wishes to strengthen the partnership with pharmaceutical industries and academic institutions; both have now developed a fantastic “panoplia-armamentarium” of new drugs, instruments and devices, and their progress will be clearly focused on subtle parameters such as graft quality and quality of life of the recipient. Partnership therefore remains mandatory for the future progress of transplantation.

Promotion of transplantation research is an important part of ESOT’s mission. With the support of Astellas, Roche, Novartis, Fresenius, Genzyme and Kohler Chemie, different grants are made available for younger physicians aiming at a career in the field of transplantation.