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Small Group Moving Forward

Samuel Goldfarb, MD
The Children's Hospital of Philadelphia

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samuel goldfarbThis year marks the 10th year anniversary of the International Pediatric Lung Transplant Collaborative (IPLTC). This collaborative represents roughly 60 physicians and nurses from around the world who are involved in pediatric lung transplantation. The IPLTC was initiated with four goals in mind:

  1. To unite pediatric lung transplant centers (to date approximately twenty centers have joined).
  2. To promote interaction to enhance the care of lung transplant candidates and recipients.
  3. To exchange ideas about the science and art of pediatric lung transplantation.
  4. To establish a prospective database of pediatric lung transplant recipients.

The above mentioned goals were all carefully crafted by Dr. Albert Faro, the IPLTC's first president, and other members into the IPLTC bylaws.

Like many great ideas, the natural response of any reader (if I have maintained your interest thus far) is, "well, what happened?" Did Faro et al move a small group with a common goal forward? I would have to say yes. In 2006 the IPLTC completed its first major accomplishment by publishing the Executive Summary on Pediatric Lung Transplantation in the American Journal of Transplantation. After that, everything else seemed to get easy. The IPLTC meets annually at the ISHLT and has regular email contact in a list serve that discusses ongoing issues along with case presentation. In 2007 the first IPLTC immunosuppression and infection treatment protocol was written. This was a group effort that addressed many aspects of the medical management of pediatric lung transplantation. Individual members/centers were assigned areas of treatment to address. This protocol was reviewed and approved by IPLTC members and the IPLTC protocol was formed. The concept behind this standardization of therapy was to improve our ability to assess outcomes. This protocol is in the process of being updated and will be completed by mid-year.

The IPLTC laid important groundwork for the application from a consortium of members to seek funding through the NIH Clinical Trials in Transplantation for Children (CTOT-C) program. Led by Stuart Sweet and Lara Danziger-Isakov, an observational study of the impact of respiratory viral infections on outcomes following pediatric lung transplant was one of four funded consortia. Based on comments made by the grant reviewers, strengths of the application included evidence of collaboration within the IPLTC, particularly the shared IPLTC immunosuppression protocol and the publications involving infectious complications authored by Dr. Danziger-Isakov and colleagues. This CTOT-C is currently nearly complete and promises to become one of the cornerstones for further collaboration.

While not all centers are involved in the CTOT-C study, this has not limited the IPLTC's ability to be a productive research group. A quick search of Pub Med will reveal 19 peer reviewed manuscripts that have been co-authored by IPLTC members from two or more centers over the past 10 years. This collaboration is ongoing with several ongoing research endeavors in various stages of completion from this group.

I believe the future is bright for this small group. While the fourth goal of a prospective database might have been momentarily lost (along with steak dinners at the annual meeting) to a bad economy, it is not forgotten. The IPLTC will continue to focus on its original goal, which is to advance the treatment and care that is provided by group members to their patients. The strength of the IPLTC lies in its ability to work together to arrive at consensus with the understanding that together our group can have a greater impact on patient care.

Disclosure Statement: The author has no conflicts of interest to disclose.