New YAU working group on kidney transplantation

10 October 2021 By Dr. Angelo Territo

Nowadays, kidney transplantation (KT) is considered the best treatment option for patients with end-stage renal disease, with more than 20,000 KTs being performed each year in Europe. Given the epidemiological relevance and the clinical importance of chronic renal failure disease and KT, as well as, the fundamental role of the urologist in this field, a dedicated Young Academic Urologists (YAU) Working Group can prove beneficial. Accordingly, in June 2021, the YAU Working Group dedicated to KT was created, following the proposal of Angelo Territo and thanks to the support of the EAU – YAU board.

Members of the group
Angelo Territo (Chairman, in the photo above): Since 2015, I have dedicated myself to KT as well as minimally-invasive surgery and urooncology. I had my first fellowship in 2015 at Fundació Puigvert in Barcelona (ES) under the supervision of my mentor, Dr. Alberto Breda. In 2016, I was selected for the European Urological Scholarship Programme (EUSP) and partook in an investigative project entitled “Development of a cold ischemia device to improve the temperature control of the graft during KT”. Recently, the step-by-step development (from dry lab to animal model and lastly human testing) of this innovative device was reported in the literature (Territo et al., Eur Urol, May 2021). Finally, in 2018, I performed an additional fellowship on robotic surgery at the Rijnstate Hospital in Arnhem (NL) to further improve my robotic skills and abilities.

Riccardo Campi (Ex officio): Since the beginning of my training, I have developed a strong passion for KT, and I am glad to have the opportunity to work in this fascinating field of urology from both clinical and research perspectives. I am currently following a Ph.D. programme focused on robotic KT at the University of Florence (IT). I believe the “world” of KT is truly inspiring for urologists and represents a unique opportunity to grow as a surgeon, being exposed to challenging clinical scenarios and stimulating surgical techniques. It is a huge honour for me to contribute to the YAU KT group. We aim to provide highquality research through multi-institutional collaborations across Europe and beyond, harnessing the power of young and talented physician-scientists wishing to reinforce the role of urologists in this amazing field.

Romain Boissier (Full member): There is so much urology and daily activity in KT that it is an invaluable asset for those who wish to become a urologist. As far as my research activity is concerned, I studied the applications of cell therapy for the evaluation of the quality of the transplant. This led me to investigate the modulation of inflammation of the KT during preservation and urological malignancies in candidates for or recipients of KT. The EAU is the cornerstone of KT in Europe. In 2016, I joined the EAU Guidelines panel on KT which was chaired by Dr. Breda, and in 2017, the EAU Section of Transplantation in Urology (ESTU), which was chaired by Prof. Dr. Enrique Lledó Garcia. Financial support from the EAU enabled me to complete a one-year fellowship at Fundació Puigvert.

Vital Hevia (full member): Currently, I am working at Ramón y Cajal Hospital in Madrid (ES). This is a very active institution in KT, which, under the direction of my mentor Prof. Francisco Javier Burgos Revilla, maintains extensive clinical, educational, and research activities in the field. Therefore, I have been able to develop a wide range of activities related to KT, including my Ph.D. on oxygen supplementation during hypothermic machine perfusion, which I expect to conclude this year. Additionally, I have the privilege of being part of the EAU Guidelines on KT as an Associate Member under the leadership of Dr. Breda. Lastly, it is my pleasure to be an Associate Member once again of the ESTU Board, which was chaired by Prof. Lledó.

Thomas Prudhomme (Full member): I am currently in my last year of residency at the University Hospital of Toulouse (FR), a renowned centre for KT. My most prominent recent research activities in KT include the assessment of a three-dimensional laparoscopic device for living donor left nephrectomy and evaluation of the safety of new BPH endoscopic surgical procedures in KT recipients. Furthermore, I have completed a Master of Science degree focusing on organ preservation and reconditioning using hypothermic machine perfusion and I plan to develop this into a Ph.D. thesis this year.

Missions of the group and collaborations
One of the main missions of the group is to emphasise the role of the urologist in KT, motivating urologists to engage in this broad field, including during pre-transplant urological evaluation, organ retrieval from both living and deceased donors, the performance of vascular suture, and management of intra- and post-operative complications. However, given the multifaceted nature of the KT field, the creation of multidisciplinary teams will be promoted, involving general and vascular surgeons, nephrologists, and transplant coordinators.

Furthermore, collaboration with other YAU groups, EAU offices, and sections (ESTU, ERUS RAKT group, etc.), and EAU Guidelines panel members will be fundamental in potentiating any initiatives on clinical, basic, and translational research in all fields of KT. Finally, the group will try to establish cooperation between different European countries to extend the kidney exchange programmes “beyond the national borders”.

Research activity and educational projects
The research activity will address several issues in the settings of both conventional open KT and emerging robotic surgery. In particular, investigations will be conducted on topics such as urological malignancies in KT recipients, polycystic renal disease and KT, the learning curve in open KT, and the use of innovative devices to ensure better graft preservation during KT.

As far as educational projects are concerned, the KT group will promote the development of a structured curriculum for open KT and surgical training in high-volume KT centres through clinical visit or fellowship at the highest volume European centre for KT. In fact, combining research activity with surgical training can be a more exciting way of promoting interest in KT.

The YAU Working Group dedicated to KT is a new section, promoting the combination of clinical research and improved surgical skills in the field. Applications for membership of the group are encouraged and will be evaluated according to the YAU selection criteria and the motivation for wishing to become part of the group.

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