The Transplantation Society Recognition Awards 2008

At each international congress, The Transplantation Society recognizes individuals who are actively making a current and significant contribution to the fields of basic and clinical sciences of transplantation. The awards, each of which is sponsored, are designed to highlight the work being performed in a number of specific areas and are awarded by the Council of TTS on advice from the Awards Committee. The 2008 awardees are as follows. Outstanding Achievement Transplantation Science (Basic) (Sponsored by Roche) The sciences which support innovation in transplantation are a vital part of the clinical practice of our young field of endeavor. The scientists who work predominantly in the laboratories do not often have the immediate gratification of seeing the people who benefit from their work, but a breakthrough in science provides benefit to millions. The winner of the 2008 award is: Jean-Paul Soulillou (Fig. 1): Jean-Paul has created one of the major global transplant research programs with 100 researchers devoted to transplantation science, supporting an innovative clinical program. Most of his work has been devoted to immunointervention in animal models of transplantation including pregraft donor cell priming, anti-donor class II, anti-IL2R and anti-CD28 and related mechanisms of action. In the same field, his group has introduced for the first time anti-IL2 receptor in humans and initiated the first trials of anti-ILF1 and anti-CD4 in human recipients. Jean-Paul has also been interested in the role of both passive and active sources of antibody in human rejection, tolerance and disease relapse as well as in xenotransplantation. He has described new methods for analyzing T-cell receptor alteration and identified molecular blood markers of immunological risks in human transplantation.FIGURE 1.: Jean-Paul Soulillou.Outstanding Achievement Transplantation Science (Clinical) (Sponsored by Roche) Research in the clinical science of transplantation is challenged by the impossibility of conducting most of the clinical studies that would provide the answers to our many questions. The ability to breach that barrier through ingenuity, statistical methodologies and careful measurement, and analysis of clinical practice has been exemplified by studies reported by: Dr. Brian Nankivell (Fig. 2): Brian studied medicine at the University of Sydney, trained in nephrology and received a Master of Science in experimental pharmacology from KQC, London. After completing his RACP fellowship, he undertook a PhD with the University of Sydney in the pathophysiology of chronic renal failure involving tubular injury and proteinuria. His second doctorate in medicine evaluated GFR estimation and renal dysfunction in kidney transplant recipients and endocrine function of pancreas transplants. His research interest then turned progressive kidney transplant failure and its pathological manifestation, formerly known as chronic allograft nephropathy. Using the large database of sequential protocol kidney biopsies from Westmead Hospital linked to clinical data, the mechanisms of nephron loss were elucidated and related to acute rejection, ischemia-reperfusion injury, subclinical and chronic rejection, calcineurin nephrotoxicity, and donor disease. Transplant damage was found to be time-dependent, compartment specific and multifactorial, and usually irreversible, this was formulated as the “cumulative damage hypothesis.”FIGURE 2.: Dr. Brian Nankivell.Excellence in Translational Science (Sponsored by Roche) The gap between experimental research and clinical application is one that requires great effort, ingenuity, and perseverance to breach. Research answers in the laboratory are essential to planning clinical experiments to extend research knowledge to clinical practice. Preservation of the live organ to extend cold ischemia time was a major goal of the transplant programs of the 1970s and 1980s. It is thus with the great pleasure that The Transplantation Society acknowledges the lifetime of work of: James Southard (Fig. 3): James collaborated in the laboratory with Dr. Folkert Belzer in the clinical program in Wisconsin to study the methods of preservation of organs for transplantation. Experimental models provided the opportunity to develop cold storage solutions that provided successful preservation for up to 3 days for kidneys and pancreas and 2 days for the liver. University of Wisconsin solution contains agents to suppress hypothermia-induced cell swelling, blockade oxygen radical injury, and agents to stimulate energy regeneration after transplantation. Translating this experimental knowledge to clinical practice is one of the few successes of translation from the academic environment to clinical practice without the investment of a major pharmaceutical company.FIGURE 3.: James Southard.Worldwide Impact in Transplantation (Sponsored by Roche) Although the field of transplantation crosses the world, most of us only have the ability to impact on patients through our local clinical practice. There are exceptional individuals who span the global in their impact. It is through understanding the true impact that our colleagues have in various countries in the world that TTS has selected: Dr. Rafael Matesanz (Fig. 4): In 1989, Rafael took the decision to change from his role as a clinical nephrologist, to start a new project, then hardly more than a dream: the Organisation Nationale Transplant. Now, almost 20 years later the so called Spanish Model of Organ Donation has become an international reference in organ donation. The implementation of a set of measures, mainly of organizational nature, around a network of highly trained and motivated physicians with the main responsibility of developing a proactive donor detection program, has resulted in a sustained increase of deceased organ donor rate from 14 to 33–35 donors pmp during the last years, by far the highest ever reached by a single country in the world. The application of this model to other countries across the world has proven to be feasible in Italy and now in South America. Rafael has demonstrated that a positive change in organ donation rates can be achieved if well planned steps are taken and as a result thousands of lives would be saved.FIGURE 4.: Dr. Rafael Matesanz.Excellence in Transplant Infectious Disease (Sponsored by Roche) Although all of us are working toward elimination of the need for expertise in Transplant Infectious Disease, high infection risk remains a reality faced by all transplant recipients. The field has thus had to look to our colleagues in the infectious disease specialty to help us obtain better results. Many of the most important advances in safety of transplantation over the past 15 years have come from better infection prophylaxis and diagnostic approaches. It is with great pleasure that The Transplantation Society recognizes the contributions of: Jay A. Fishman (Fig. 5): Jay is the well known Director of the Transplant Infectious Diseases and Compromised Host Program at the Massachusetts General Hospital, Associate Director of the MGH Transplant Center, and Associate Professor of Medicine at Harvard Medical School in Boston, Massachusetts, USA. Dr. Fishman is an internationally recognized expert in infectious diseases related to transplantation and has trained many of the leaders in this field and is a Past-President of the American Society of Transplantation. He has a special interest in molecular diagnostics, transplant virology and mycology, and in medical education. Dr. Fishman’s clinical and research interests focus on the pathogenesis and prevention of infection in the immunocompromised host. His laboratory is investigating infectious disease issues related to xenotransplantation and the role of viral infections in transplantation.FIGURE 5.: Jay A. Fishman.Innovation in Surgery and Technology (Sponsored by Genzyme) The 1960s were steeped in surgical innovation as surgeons worked to perfect the procedures used to transplant organs. The kidney, liver, heart, lungs, pancreas, intestine, and more recently various composite grafts have challenged surgical skills since that time. One of the more recent innovations has been to develop living liver donation and transplantation. The challenge to create a safe procedure for both the donor and the recipient has added to already complex liver surgery. There are a number of centers and individuals who have progressed this field and it is both for his skill and his rigorous approach to the area that The Transplantation Society recognizes: ST Fan (Fig. 6): Known to all as “ST,” Professor Fan is Chair of the Department of Surgery at the University of Hong Kong where he designed and performed the first living donor adult to adult right liver lobe transplantation in 1996. He has been dedicated to both undertaking and improving the procedure as well as measuring the detailed outcomes. He is now responsible for the development of a liver transplant registry for all China. His surgical innovation from the laboratory to the clinical operating theater have had a significant influence on the practice of liver transplantation globally and helped to usher in a new era for patients in need of liver transplants.FIGURE 6.: ST Fan.Education and Training in Transplantation (Sponsored by Genzyme) Spreading the word and spreading the skills that are used in clinical transplantation are vital to implementation of improvements. The multitude of educational and training systems that we have in each country provides a patchwork of programs through which the seeker of skill and knowledge must chart their own course. The exception is the area of organ donation where everyone knows the unique place that has been forged by the group in Barcelona lead by a uniquely capable educator: Marty Manyalich (Fig. 7): Marty established “Transplant Procurement Management” in 1991 under the auspice of the University of Barcelona as a specialized professional training project. TPM is a strategic international system approach to combating the global organ and tissue shortage. TPM has worked together with the development of the “Spanish Model” by educating and training health professionals for 17 years. Its main goal is to increase the quantity, quality, and effectiveness of organ and tissue donation for transplantation, by training and advising health care professionals in all the major steps of the donation process. Over 5900 participants from 91 countries have benefited from training in both traditional face-to-face, on-line and blended learning modalities.FIGURE 7.: Marty Manyalich.Outstanding Investigator driven Clinical Trial (Sponsored by Novartis) In the world of regulatory pharmaceutical development and with the heavy costs of clinical trials consequent on the large numbers required to achieve statistical power, the independent clinical investigator has become an endangered species. It is with this background that The Transplantation Society sought to recognize and encourage the clinical investigator to redouble efforts and derive evidence for improving organ transplantation in ways that may not be commercially relevant. An outstanding proponent of this work is: Rutger J. Ploeg (Fig. 8): Rutger comes from The Hague in the Netherlands and was educated at the University of Leiden with electives in Indonesia, Toronto and Cambridge. He was trained as a surgeon at the Leiden University Medical Centre and during a research fellowship with Dr. F.O. Belzer he became interested in ischemia-reperfusion injury and preservation in transplantation. He was involved in the experimental studies and clinical introduction of the University of Wisconsin solution. After 2 years at the University of Wisconsin in Madison from 1991 to 1993, he returned to the University Medical Center Groningen in the Netherlands where he has been a Professor of Surgery since 2001. He is currently Secretary of the European Society for Organ Transplantation. In the decade, he has intensively focused and published with his group on questions how to better maintain or enhance organ viability and characterize the mechanism of injury and repair during brain death, retrieval, preservation to improve early function after transplantation using innovative methods, or interventions in the experimental setting and translational and clinical studies.FIGURE 8.: Rutger J. Ploeg.Outstanding Contribution to the Evidence Base for Transplantation (Sponsored by Novartis) The “evidence” on which we base our clinical decisions is surprisingly slim when examined in the hard cold light of accepted international criteria—the controlled trial, the meta-analysis, and the epidemiologists’ analyses. In transplantation, we have slowly developed a methodology of “keeping the data” and with that effort we have been able to derive evidence for things that we should do and things that we should not. Foremost among the protagonists for exposing the sometimes uncomfortable truth has been: H. -U. Meier-Kriesche (Fig. 9): Ulf is currently the Professor of Medicine and Medical Director of the Renal and Pancreas Transplant Program at the University of Florida, Gainesville, Florida, USA, and the Central Florida Kidney Center Endowed Chair in Medicine. He is recognized for his research in outcomes of kidney transplantation and for his studies on the use, metabolism, and complications of immunosuppressive drugs. Professor Meier-Kriesche has received numerous prestigious awards and his research interests include study design and outcomes research in renal transplantation, immunosuppressive protocols in transplantation and their effect on chronic allograft failure, and the identification of factors affecting transplant organ and patient survival.FIGURE 9.: H.-U. Meier-Kriesche.

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