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Editorials and Perspectives: Special Feature

The Transplant Library of Randomized Controlled Trials and Systematic Reviews

Pengel, Liset; Morris, Peter

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doi: 10.1097/TP.0b013e31822cdc70
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In 1978, the renowned Archie Cochrane in an essay on the future of medicine said “It is surely a great criticism of our profession that we have not organized a critical summary, by specialty or subspecialty, adapted periodically, of all relevant randomized controlled trials.” This did of course eventually result in the creation of the Cochrane collaboration and the Cochrane library of randomized controlled trial (RCT), but this is large (more than half a million references), it is not organized by specialty, and one does need some more sophisticated search skills to get what you want. Thus, the Transplant Library, where minimal search skills are required, is the first such specialized library that Cochrane identified as being a necessity some 40 yr ago.

In the Transplant Library, all the work has been performed for you in that the trials are classified by the organ concerned, and furthermore, it includes references from conference proceedings to RCTs, which are not available in Medline.

The Transplant Library contains some 7500 references to RCTs and includes more than 3500 references to abstracts of RCTs in conference proceedings, many of which do not ever come to be published.

Another aspect of the Library is that from January 2004 all trials are graded for the quality of the methodology using allocation concealment, intention to treat analysis, and the Jadad score, which takes into account appropriate methods of randomization, blinding, and follow-up. From January 2008, selected good quality systematic reviews and meta-analyses have also been added to the Library.

The Library is updated every 2 weeks for RCTs and lists many trials that are published electronically ahead of print, whereas the addition of selected systematic reviews is performed on a monthly basis.

The Library is an incredibly useful tool for the transplant clinician or healthcare worker in transplantation as it enables one to see what is available in level 1 and level 2 evidence quickly without any sophisticated search knowledge.

In the following pages, there is a guide to the use of the Library, and we hope you will find this useful. Please contact us if you have any questions.

Journal subscribers have access to the Transplant Library as part of their subscription. You can access the Transplant Library through the home page of the Journal. It may also be available through your institution or membership of the BTS and ESOT.

Guide to Using the Transplant Library


The Transplant Library has been developed by the Centre for Evidence in Transplantation in collaboration with Wolters Kluwer Health. The Library aims to provide high level evidence-based information on all aspects of solid organ transplantation and will serve as an easily searched resource for clinicians, researchers and other related health professionals.

The Transplant Library consists of:

  • Randomized controlled trials (RCTs) from 1970 to present. There are over 7,500 references in the library, sourced mainly from Medline, the Cochrane Library (with permission) and hand searches of conference proceedings resulting in over 3500 abstracts from conference proceedings.
  • Selected systematic reviews and meta-analyses of good quality from 2008 onwards (150 references).

Other features of the Transplant Library include:

  • A simple and intuitive search interface on the OvidSP platform allowing rapid and comprehensive searches on focused topics without any professional search skills
  • Unique limits specific to organ transplantation to make searching even faster and more effective
  • Methodological quality rating for studies published from 2004 onwards which helps users assess their potential value. The methodological quality rating consists of the Jadad scale and the items allocation concealment and intention-to-treat analysis.
  • Updates with new RCTs every two weeks (many ahead of print publication). Good quality systematic reviews are updated every month.

Visit for more information on the selection and assessment of RCTs and systematic reviews.

The Database Field Guide provides more detailed information on the Transplant Library and is available by clicking on the SYMBOL. The date next to the icon indicates when the Library was last updated.



The Transplant Library is available on the OvidSP platform and there are several ways to search the library. In this brochure the ‘Basic Search,’ ‘Advanced Search’ and ‘Find Citation’ search options will be explained. You can find more information regarding the other search options in the Database Field Guide SYMBOL.


The basic search option can be used for quick and simple searches (Fig. 1).

Basic Search Screen.

Key Features of the Basic Search Include:

  • Based on natural language; you can simply enter a term, different terms or a phrase.
  • Searches can be limited to organ type, publication type (RCT or systematic review), pediatric patients, references with a methodological quality score or English language. There is also a limit to exclude congress abstracts from the search results.
  • By selecting the “Include Related Terms” box the search is expanded to include plurals, alternative spellings and related words.

The results box displays the results of your search (Fig. 2).

Basic Search Results.

Key Features of the Results Box Include:

  • “Results Tools” box displays the terms used in the search.
  • References retrieved in the basic search mode are listed according to a relevance score which is indicated by the stars at the top left corner of each retrieved record. The relevance score is based on the relevance of the record to the search terms entered and ranges from 1 to 5 stars. This is NOT a methodological quality score.
  • References can be sorted according to a number of criteria using the ‘Sort by’ drop-down list. For example, you can sort by year of publication to order references from the most recent to the earliest record.
  • “Quality Score Available” is displayed for RCTs that have been assessed for their methodological quality by the Centre for Evidence in Transplantation.


The advanced search option should be used when performing a comprehensive search to identify all records on a topic (Fig. 3). Select the advanced search option by the “Advanced Search” tab in the search box.

Advanced Search Screen.

The advanced search allows the user to search by keyword, author, title and journal.

It also provides the ability to search using Medical Subject Headings (MeSH). The Transplant Library can be searched using the thesaurus of controlled vocabulary of the National Library of Medicine called the Medical Subject Headings system” or “MeSH”. Each article is assigned a number of MeSH terms (Subject Headings) to describe the content of the article. It ensures that articles indexed according to the same MeSH term can be retrieved regardless of the terms used by the author. When searching using MeSH terms always ensure that the “Map term to Subject Heading” box is ticked.

To search for a MeSH term, or find out whether a MeSH term exists for a particular topic:

  • Enter the term, for example “Neoral”, and ensure that the “Map term to Subject Heading” box is ticked. Then click “search”–this will bring up the box in Figure 4.
  • FIGURE 4.
    FIGURE 4.:
    Mapping terms to subject headings.
  • In this example, the search term “Neoral” is mapped to the MeSH term “Cyclosporine”.
  • You can choose to “Explode” (for a broad search) or “Focus” (to narrow the search results) the MeSH term.
  • By clicking on “Scope” the scope note will be displayed containing more detailed information about the term including used-for terms.
  • Click “Continue” which will display the box in Figure 5.
  • FIGURE 5.
    FIGURE 5.:
    Selecting subheadings.
  • You can select relevant subheadings or tick the box “Include all subheadings”. The number of records for each subheading is indicated in brackets.
  • Click “Continue” to display the search results.


This search option can be used when looking for a particular paper but only part of the bibliographic citation is known. You can search for an article using one or more fields (Fig. 6).

Citation search by either author, title, journal, etc.
© 2011 Lippincott Williams & Wilkins, Inc.