Summary by Dr. Georgi Abraham, Consultant Nephrologist, Chennai

The Eighteenth International Congress of the transplantation society was held in the famous city of Rome in the last week of August and the first week of September this year. The highlights of the meeting were the inaugural  Holy Mass  celebrated at the St Peters Basilica in Vatican  which was attended  by  four  thousand delegates  and one thousand four hundred  accompanying  persons. His Excellency Cardinal David Isridy conducted the mass. His Holiness Pope John Paul II addressed the delegates on the second at the Palazzo Dei Congressi and highlighted the importance of organ donation with out commercialisation for saving human lives. His Holiness also spoke strongly against cloning humans for organ donation. Dr. Ian Wilmut who did the first cloning which lead to the birth of Dolly, spoke about cloning. This has created enormous interest in research with application in transplantation therapy in two ways. These are the provisions of organs, tissues and cells from animals and second the development of methods for production of human cells for therapy. There are many debates going on in the community about the ethical aspects of producing human cells for therapy.

The Medawar prize was received by Ray Owen, Professor of the California Institute of Technology who did the first skin grafting in 1945 (first successful transplant) between identical twins.

Dr. Roberts Schwartz, Associate editor of New England Journal of Medicines was the other recipient of the Medawar prize. In receiving the noble prize (1960) Sir Peter Medawar said that he should share it with Prof. Owen Robert Chwartz introduced the first meaningful l immunosuppressive work with 6 Mercaptopurine. Dr. Sir Antonio  Lanzavecchia, from Switzerland stated that immune system has evolved for several hundred million years in order to learn to recognise the pathogens from the tissue of an individual from the same species and hence transplant  rejection is a mere accident. It was highlightened that the dendritic cells are the antigen presenting cells (APC).  These alerts the immune response through T- Lymphocytes and the cascade continues leading to rejection. Prof. Nichole Suciu Foca of the Columbia University of New York stated that “Avoiding graft rejection” the dream of all scientists working in the field of transplant may not be Uthopia anymore, but a reality. It has been possible to locate a gene responsible for major role in the suppression of immune response for transplant. Gene therapy in future will enable us to control the big chemical cascade including immune tolerance, mimicking natural pathways and reducing unwanted reactions due to pharmacological intervention. Secondly, the possibility of creating transonic pig with human genes that controls the immune system, specifically the inhibition of the immune reaction.

In the field of transplant surgery multi visceral transplantation was discussed as it has become a reality. In the field of Cadaver Organ donation Spain is the world’s leading country in donation. Every year more and more people decide that for transplantation Spain is better than their home country. Spain’s excellent performance in raising donation figures has four different reasons they are:

First, the efficiency of communication campaigns aimed at creating individual awareness on the problem of organ shortage.

Second, the Continuous monitoring of transplant activities.

Third, transplants and post surgery medical assistance given free of charge.

Fourth, transplant centres with the best performance are entitled to receive financial incentives in the field of new immunosuppressive drugs.

Novartis has three drugs in the pipelines which are in various phases of trials. Cellcept, Sirolimus, Neoral and Tacrolimus along with Simulect and Zenopax still remaining the mainstay of anti rejection therapy.