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Education and Science Across the Borders: European Networking at ECTTA Meeting

Marco Masetti, MD, PhD
University of Bologna
Bologna, Italy

Javier Carbone, MD, PhD
Hospital General University Gregario Marañon
Madrid, Spain

Last October, the second European Cardio Thoracic Transplant Association (ECTTA) Meeting took place in Barcelona, Spain.

This small part of European Society for Organ Transplantation (ESOT), born in 2013, organizes every other year a congress in Europe (the first took place in Budapest in 2014). The birth of this Society originated from two necessities: the need of representing the scientific issues of heart and lung transplantation and mechanical circulatory supports within ESOT, and the aim of improve the network between European people working in this field. One of the main goals of ECTTA, like the other international scientific societies, is to encourage research networking and the exchanges programs between young people within the small Europe.

Beside the objectives of the Society, last ECTTA Meeting was stimulating both from the point of view of a young member attending the Meeting for his first time, and for an expert senior physician in the field of heart and lung transplantation.

For a young member, of great interest was the core competence course about heart and lung transplantation, that preceded the Meeting; main topic treated were: heart or lung procurement primary graft dysfunction, the role of antibodies in rejection and different sensitization protocols. In the talk "immunology for dummies", the basic mechanisms involved in transplant immunology were explained by Dr Carbone; in the afternoon, the interactive discussion of difficult clinical cases within small groups facilitated the exchange of opinions between experts and young faculties.

In the following two days, the sessions were organized with the joint participation of EDTCO, the European Organization of Transplant Coordinators, and ETAHP, the European Healthcare Professionals Association, another initiative with the goal of spread the knowledge about transplant. Dr Stehlik presented the latest reports from ISHLT Registry, underscoring the importance and the limits of registries.

Some specific invited talks from non-European and European guests raised great interest. Kiran Khush, from Stanford University, gave an outstanding talk about the role of immune monitoring and of circulating cell free donor-derived DNA analysis in rejection prediction and their possible application for a personalized immunosuppressive approach. The role of genetics in the complex mechanisms of rejection needs to be further studied in dedicated high volume centers, but again the great potential of data derived from AlloMap registry has been evocated. Another fascinating presentation was given by Phillip Halloran, from Edmonton University: in his talk, he underscored the role of molecular biology in characterizing the different phenotypes of cellular, antibody mediated or mixed rejection. The molecular basis of cardiac rejection appears to be quite similar to other organs, like in the kidney, where they have been more investigated, thus suggesting the presence of shared, stereotyped mechanisms regardless of the organ system. The use of molecular biology appears to be more sensitive than histology in characterizing some types of rejection, and maybe in guiding medical treatment. Preliminary data of INTERHEART project, where different European and non-European centers were involved, seem to support this hypothesis.

Peter MacDonald, after giving insights about pathophysiology of brain death and of donations retrieved after cardiac death (DCD), gave a very important talk about the role of machine perfusion in optimizing the quality of the donor heart, both in extended DBD and DCD donors.

Regarding lung transplantation, the main topics were different lung allocation systems in Europe, the role of ECMO in lung transplantation and of ex vivo lung perfusion. Dr Haverich from Hannover gave a very interesting and pioneering talk about fully implantable artificial lungs.

Several abstracts were awarded, through travel grant and funds, mainly dedicated to young people, both in the field of heart and lung transplantation, like primary graft failure, ex vivo lung perfusion, bridging to transplant with a MCS, risk stratification after heart transplant, antibody mediated rejection.

In conclusion, this small and newly born section of ESOT, even if it still needs to grow in several issues, is oriented to be a very open society, encouraging the participation of various professional figures working in different fields, and it promises to be a valid tool to improve medical knowledge and scientific connections within Europe. In the contemporary times, where national interests seem to overcome the international views, ECTTA experience represented a small boost to improve networking across the borders. ■

Disclosure Statement: The authors have no conflicts of interest to disclose.

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