The 17^th ESOT Congress held in Brussels, Belgium on September 13-16, 2015 had a great success with more than 3500 participants from over the world.

The Scientific program included 85 lectures by top experts in the field, 772 oral/mini-oral presentations and 811 posters.

Besides different State of the Art sessions dealing with several, still burning questions about organ donation and transplantation, many important European contributions in the field of organ and tissue transplantation as well as procurement were highlighted. Major focuses of the Congress were on the strategies for expanding the donor organ pool such as machine perfusion, induction of transplantation tolerance, but also on novel technologies aiming at constructing artificial or bio-artificial organs, or utilizing cell-based technologies, which could successfully solve organ shortage and lifelong immunosuppression issues. Attention was also given to the European view in relation to ethical and legal aspects in the field of donation and transplantation.

Several presentations covered the different aspects of immunomodulatory properties of adult stem cells in the context of the treatment of graft versus host disease. A clinical study carried out by Professor Morelon’s group (Lyon, France) showed that infusion of adipose-derived mesenchymal cells (ASCs) could control GvHD (graft versus host disease) and prolong survival of vascularised composite allografts (VCAs). This was performed in patient who underwent bilateral hand transplantation in 2007 and received an immunosuppressive treatment (IST) based on steroids, tacrolimus and mycophenolate mofetil, with ATG induction. The patient developed several episodes of AR (acute rejection). Because of the high number of AR episodes recipient ASCs were prepared and infused IV. IST remained unchanged the first 2 weeks after infusion. Six weeks after infusion, grafted skin was almost normal. Neither side effects nor complications have been reported so far.

Encouraging results on the first bioengineered mini pancreas transplant in diabetic patient were presented at State of the Art session by Professor Camillo Ricordi (Diabetes Research Institute, Miami, FL, USA). The donor islets embedded within a biodegradable scaffold (made by combining the patient’s own blood plasma with thrombin) were implanted on the surface of the omentum. The patient with most severe Type I diabetes underwent the minimally invasive procedure on August 18, 2015, and started to produce insulin soon after the transplantation. Short-term results of the trial are quite promising and if confirmed, definitely will open a new era in islet transplantation. The ultimate goal of the Professsor Ricordi and his team is to include additional technologies to prevent the need for life-long immunosuppression therapy.

Three-dimensional (3D) bioprinting is driving major innovations in medicine. Recent advances have enabled 3D printing of biocompatible materials, cells and supporting components into complex 3D functional living tissues. The advent of 3D bioprinting has generated enormous interest in regenerative medicine to address the need for tissues and organs suitable for transplantation. Lecture: “Printing the human body” delivered by Professor Jackson from Wake Forest Institute for Regenerative Medicine addressed several issues, such as the choice of materials, cell types, growth and differentiation factors, and technical challenges related to the sensitivities of living cells and the construction of tissues. The group has already generated and transplanted several tissues, including multilayered skin, complex muscle-tendon construct, bone, heart tissue and cartilaginous structures.

To address the issue of donor organ shortages an innovative approach is being developed by the team led by Professor Hiro Nakaushi (USF, San Francisco, CA, USA). The Scientists have successfully “grown” a functional pancreas inside a pig by two-step procedure. Firstly they generated transgenic pig embryos overexpressing the Hes-1 gene under a Pdx-1 promoter, which suppressed pancreas development, creating a “niche” for growing a new panceas. Next, they injected normal pig’s induced pluripotent stem cells (iPSCs) into the embryo of pancreas-defective pigs and observed that these cells were able to give rise to a fully functioning pancreas. The same technology was tested with rats and mice, where mice iPSCs were transplanted into the embryos of rats that were unable to form a pancreas. As a result full development of a mouse pancreas was seen in the rat. Professor Nakauchi addressed various problems including possible chimerism of porcine cells within the human organs grown in the pig, which may cause immune problems once the organ is transplanted into humans.

Overall this interesting Congress more than lived up to its motto of ‘Beyond the Horizon’ in transplantation by covering the enormous scientific progress in transplantation, bioengineering and cellular technologies recorded in recent years.