The transplantation landscape is changing with the evolution of new surgical techniques and improvement in cell and tissue culture which are allowing an expansion of life saving, changing and giving transplant opportunities. The recent survey by the World Transplant Games Federation regarding autologous Bone Marrow Transplantation (BMT) was circulated to all the member country representatives seeking a view on whether autologous BMT recipients should be allowed to participate at the World Transplant Games (WTG) in future. Lynne Holt as the Transplant Sport Team GB country representative consulted the Transplant Sport Trustees for the current Transplant Sport view and the Team GB Captains. Transplant Sport (TS) currently holds the long-term view that participants at TS events should have life changing and life saving organ transplant which are supported by long-term immunosuppression. There has for some time been a discussion about allogenic versus autologous BMT, and the decision to include autologous BMT recipients as participants at the WTG by the member countries of the WTGF raises the debate again. There are several current anomalies in that not all organ transplant recipients are, or remain on, immunosuppression and indeed newer autologous cell therapy techniques are allowing a dramatic reduction in the immunosuppression load. A number of liver transplant recipients have been successfully withdrawn from immunosuppression and remain rejection free and historically identical twin donor-recipient pairs have not required immunosuppression. There are other forms of autologous life saving transplants including kidney transplantation for renal cell cancer with implantation of the autologous organ by a transplant surgeon in the standard transplant kidney site. This procedure prevents dialysis dependency and improves patient survival. We now have the potential to perform a range of composite tissue transplants which are life changing such as limb, face and hand transplants, such recipients cannot currently participate in TS events. In addition, a new uterus transplant programme has commenced in the UK offering hope to the 5% of women born without a uterus, of giving the gift of life to future children. All of these transplant types require high levels of immunosuppression. I think the time has come for a debate within the Great Britain Transplant Sport community about the position with regard to inclusion of life saving autologous forms of transplantation, life changing forms of composite tissue transplantation and life giving uterus transplantation. We will discuss how to explore these issues at the Transplant Sport AGM in January 2025 leading to a full consultation process in 2025. There are complex issues involved which require some explanation and we will ask experts in the appropriate areas to provide some background information to aid the decision process. Trustees Transplant Sport November 2024
