One of the greatest achievements in medicine has been the facility of organ transplantation. Since the first successful kidney transplant in 1954, the field of transplantation has made tremendous progress. During the past decades, organ transplantation has become a frequently performed routine procedure offered to patients with end-stage organ failure. Long-term immunosuppressive therapy is required for the maintenance of the transplanted organ, which inevitably results in a significant inhibition of immune defenses; this leads to frequent skin infections and malignancies, which represent an important cause of morbidity and mortality for these patients.
Transplant recipients live longer, have a good quality of life, and represent therefore a rapidly growing population. Post-transplant aftercare must handle all types of problems occurring in organ graft recipients, including malignancies and infections. Organ transplant recipients are at a significantly increased risk of multiple cancers. The overall risk for cutaneous squamous cell carcinoma, the most common skin cancer in transplant patients, is up to more than 100-fold greater than the general population and by greater than 50% of the patients are affected. These malignancies are often more aggressive compared with the general population and require multidisciplinary care.
Although the follow-up, and especially the immunosuppressive therapy, are maintained by specialized transplant centers, such patients increasingly appear in dermatological offices or hospitals. Thus, there is need for an educational network for physicians and health care workers and for guidelines how to care best for this cohort of patients. Therefore, the SCOPE network (Skin care in Organ Transplant Patients Europe) was founded in Berlin in 2000 to meet the need for proper dermatological aftercare in this growing group of patients. SCOPE was initiated by Prof. Eggert Stockfleth of the Berlin Charité, now Head of the Dermatology Department in Bochum, Germany. Over the next few years SCOPE grew into a pan-European organisation. It is an interdisciplinary network of dermatologists, transplant physicians, patient support groups and basic researchers; it is the kind of network that leads to new discoveries and helps advance medicine.
Close cooperation at an intercontinental level with our sister organisation, the North-American and Australian ITSCC (International Skin Cancer in Organ Transplant Patients Collaborative Group), represents an integral part of our work. Outside transplantation increasing numbers of patients are also long-term immunosuppressive therapy due to other reasons, or are immunosuppressed because of underlying conditions such as chronic lymphatic leukemia; these patient groups will also be the focus of SCOPE.
The annual "SCOPE meetings" have become major meetings for clinicians and basic scientists working in the challenging fields of cutaneous problems in organ transplant recipients. These congresses covers all aspects of skin problems in organ transplant recipients and explores new ways of intervention and treatment. Aftercare in organ transplant patients focuses on diagnosis, treatment and prevention of infections and, most importantly, skin tumours. We select keynote lectures and abstracts discussing new developments. The emphasis is on workshops, which offer ample opportunity to discuss and to network with other professionals – leading to new ideas on how to best treat our patients. Our fruitful cooperation is reflected in several multicentre studies, and in a number of ground-breaking publications and books.
Thank you for your interest in transplant dermatology and SCOPE!
Univ. Prof. Dr. Alexandra Geusau
President European SCOPE Network