Newsletter no. 4, May 2015

Dear Working Group members,

The present newsletter is intended to update you on the activity of the working group with special focus on the educational and scientific aspects that hopefully will involve many of the members in the near future. Furthermore we would like to draw your attention to the already published and drafted publication involving Descartes.
The board of Descartes hope that you will find the newsletter of value. If you should have comments, suggestions or otherwise wish to influence upcoming newsletters or the work of the board, do not hesitate to contact the board members either directly at one of the mentioned educational sessions mentioned here, or by e-mail or similar.

Educational activities

Since the last newsletter the following educational activities have been performed by the Descartes working group:

March 22, 2014, Sarajevo, Bosnia and Herzegovina. ERA-EDTA CME course: An update in kidney transplantation for improvement of the program for developing countries
May 31, 2014, Amsterdam, the Netherlands. Joint CME symposium with EKITA at the ERA-EDTA Congress: Back to the basics of renal transplantation. The symposium contained sessions on “Hot spots in transplantation” and “The marginal donor and the fragile recipient”
October 31, 2014, Prague, Czech Republic. Joint Descartes/EKITA symposium. Eleventh Transplant Academy. The programme comprised morning sessions on tolerance, targeted immunosuppression, DSA and immunosuppression in the elderly patients and afternoon works shops in relation to these subjects.
November 28, 2014 Parma, Italy. Descartes CME: Renal transplantation in the Elderly. See the publication in preparation (below).




The educational activities have all been well received with many participants.

In the near future the following activities are planned:

May 20, 2015, London, UK. Joint CME symposium with EKITA at the 52 ERA-EDTA Congress: Tolerance, minimization and living donation in 2015. For full programme and further information, please follow the link: http://www.era-edta2015.org/en-US/cme-3
September 13, 2015, Brussels Belgium. Joint EKITA-Descartes CME symposium at the 17 ESOT Congress: Personalization in transplantation. For further details and full programme please follow the link: http://esot2015.esot.org/ekita-descartes-joint-symposium
December 11, 2015, Wroclaw, Poland. ERA-EDTA CME organized by Descartes. "Hot issues in kidney transplantation: from donor management to tolerance" For programme please follow the link: http://www.ndt-educational.org/page-23-918-0-963--hotissuesinkidneytransplantationfromdonormanagementtotolerance.php




We encourage the WG members to attend these activities and join the discussions.

Update on ongoing scientific activities
During the last 12 month Descartes have focused on developing started projects: The Senior Transplant Registry and the Reduced study (for details please refer to Descartes Newsletter No 3). Both study protocols have now been finalized and approved by Centre of Evidence in Transplantation in January 2015. It is the intention to start recruiting patients in late 2015/early2016.
The “Tolerance Study” (for details please refer to Descartes Newsletter No3) has now resulted in the official formation of a pan-European network called EUTOL. The initiative has identified a number of operational tolerant patients across Europe and is preparing an article describing the detailed characterization of pheno- and genotype of these patients. The work is proceeding as planned.
New scientific initiatives
Descartes has started one new project: Does kidney transplantation improve patient survival compared to dialysis in the current era in Western Europe? The primary goal of this study is to quantify the possible survival advantage of kidney transplantation compared to waitlisted patients on maintenance dialysis in the Western-European population with renal failure nowadays, with focus on the possible difference in benefit when using ECD or DCD versus SCD or living donor (LD) kidneys. This study will provide an analysis of graft and patient survival of the incident renal transplant population of Belgium, the Netherlands, Austria and possibly other Western-European countries. Data will be retrieved from the ERA-EDTA registry, national registries and the Eurotransplant database and will include all patients who received a first kidney transplant between 2000 and 2014. Differences in outcome between LD, SCD, ECD and DCD kidney transplantation will be evaluated and described according to recipient age. Waitlisted patients who remained on dialysis or died awaiting transplantation during the study period will serve as a control group. From the Eurotransplant database we will retrieve data from patients on the waiting list between 01/01/2000 and 01/05/2014. This database will also provide information on the donor in case of transplantation. We will also be able to retrieve (more limited) data on recipients and donors of a living donor transplantation performed within this period. It will therefore be possible to categorize the kidney donor in to LD, SCD, ECD and DCD as well as to score deceased donor kidney quality using the kidney donor risk index (KDRI). As of today, the ETKAC (“Eurotransplant Kidney Advisory Committee”) has given its approval to the realisation of this study. Both Dr. Kitty Jaeger and Vianda Steel, from the ERA-EDTA registry, have approved the study. From the ERA-EDTA database we will extract data of the same population and collect the following items: age, sex, geographic region, cause of end-stage renal disease, treatment in academic of private centre, date of start of dialysis, dialysis modality, transplantation date, date of return to dialysis, date of death, cause of death. A first meeting with Eurotransplant and ERA-EDTA registry has taken place in Amsterdam on May 23rd 2014. The principal investigator is Dr. Rachel Hellemans, nephrologist at the Antwerp University Hospital. This two to three year project could: 1. Deliver answers to several important question regarding present patient and graft survival after transplantation as compared to dialysis in various subgroup of patients; 2. hopefully help to increase the collaboration between the two large European databases, the one pertaining to Transplantation (Eurotransplant) and the one dealing with outcomes of kidney patients (ERA-EDTA Registry).
Descartes publications
Maggiore U, Oberbauer R, Pascual J, Viklicky O, Dudley C, Budde K, Sorensen SS, Hazzan M, Klinger M, Abramowicz D; for the ERA-EDTA-DESCARTES Working Group. Strategies to increase the donor pool and access to kidney transplantation: an international perspective. Nephrol Dial Transplant 2015; 30:217-22. Review. (http://ndt.oxfordjournals.org/content/early/2014/06/05/ndt.gfu212.full.pdf+html)
As a follow-up of the  Descartes CME in Parma, November 20th, 2014, dedicated to “Renal Transplantation in the Elderly”, Descartes was invited to prepare an issue for the Journal Transplantation reviews (http://www.journals.elsevier.com/transplantation-reviews/) (Editors: Stuart J. Knechtle, and Julio Pascual) related to various themes and lectures presented at the Parma meeting. The editors of this issue will be Umberto Maggiore, Klemens Budde, and Daniel Abramowicz, all from Descartes. The majority of the articles have already been written and reviewed, and the issue will be published in the second semester of 2015.
With our best regards to all Descartes members

On behalf of the Descartes Board

Søren Schwartz Sørensen