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Schweizerische Transplantationskohorte

English title Swiss Transplant Cohort Study
Applicant Steiger Jürg Ulrich
Number 134267
Funding scheme Cohort Studies Large
Research institution Klinik für Transplantationsimmunologie und Nephrologie Universitätsspital
Institution of higher education University of Basel - BS
Main discipline Clinical Immunology and Immunopathology
Start/End 01.02.2011 - 31.01.2014
Approved amount 3'677'588.00
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All Disciplines (8)

Discipline
Clinical Immunology and Immunopathology
Internal Medicine
Surgery
Clinical Pharmacology
Methods of Epidemiology and Preventive Medicine
Infectious Diseases
Mental Disorders, Psychosomatic Diseases
Occupational Medicine, Ergonomy

Keywords (6)

Transplantation; Immunology; Infectious disease; Quality of life; Epidemiology; Graft survival

Lay Summary (English)

Lead
Lay summary
Each year, approximately 300-400 solid organ transplants are performed in six transplant centers in Switzerland. For many patients with end-stage diseases, organ transplantation is often the only option to save patient's live and to improve quality of life. The success of transplantation and the continued improvement of care following listing and transplantation is therefore great public interest. Despite many achievements, transplantation medicine is still one of the very challenging areas of modern medicine. The success of transplantation is determined by the complex interplay of biomedical, psychosocial and care-related factors. For example time on the waiting list, acute and chronic allograft rejection, infections, cardiovascular disease, malignancies, consequences of immunosuppressive therapy and mental disturbances may complicate patient management and limit patient and graft survival.In 2007, a number of investigators from different disciplines launched the Swiss Transplant Cohort Study (STCS), a multicenter observational cohort study that performs nationwide follow-up of all transplant recipients in Switzerland. Since 2007, the STCS is funded by the SNF and by all six Swiss hospitals (Basel, Bern, Geneva, Lausanne, St. Gallen, Zurich) where organ transplant programs are established. Important collaboration exists with the Federal Office of Public Health (BAG) and the Highly Specialized Medicine (HSM) Board.The objective of the STCS is to integrate and coordinate all information on transplant activities in order to provide a basis for high quality clinical research across different organ transplantation programs. This unique opportunity of collaboration and sharing experience will hopefully improve the management of transplanted patients in Switzerland. It is expected, that the STCS high-quality data will contribute to the gain of knowledge in the field and facilitate international collaboration.The STCS is a so-called prospective cohort study, where defined clinical and biologic patient - and graft factors are determined at the time point of transplantation and during regular follow-up examinations. Any later re- or second transplantations are also prospectively registered in a specifically developed system. This will enable to measure the graft's longevity, the patient's survival and the causes why grafts fail or patients die.All patients with solid organ transplantations in Switzerland are enrolled. It can be noted that post-transplant monitoring of organ recipients is mandatory by federal law since July 2007 and a minimal dataset is collected in all transplant recipients. In patients who give consent, a comprehensive set of data including blood samples is collected. Through the establishment of standardized data collection and implementation of data quality monitoring we expect important insight into patients' health and mechanism of disease development.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Associated projects

Number Title Start Funding scheme
140929 Pseudomonas aeruginosa in lung transplant patients: adaptation, bacterial competition and novel therapeutic approaches 01.06.2012 Project funding (special)
108795 Swiss transplant cohort study (STCS) 01.07.2007 Cohort Studies Large

Abstract

The Swiss Transplant Cohort Study (STCS) is a recently initiated prospective open multi-site cohort study of all organ transplant recipients in Switzerland. The STCS has a novel and unique data structure (patient-case system) in a collaborative network that allows to display every transplant scenario and, therefore, to monitor the complexity of care and perform post-transplant research. Within this highly specific data structure we include a wealth of clinical and laboratory data that are collected at transplantation and subsequently updated. Outcome data like infectious diseases, cancer occurrence and the psycho-social developments build a framework for high-quality clinical and translational research.The STCS is primarily funded by the SNF and by all six Swiss transplant centers, which have mandated the STCS to record and report outcomes to BAG (Bundesamt für Gesundheit, Swiss Federal Health Office). A close collaboration with the BAG has been established on data quality monitoring. During the first year of the SNF funding period (July 2007 to June 2008), the STCS has established a well functioning infrastructure, including an executive office (EO), steering board (board of representative, BOR), scientific committee, central and local data management and various active working groups.In May 2008 the STCS included the first patients and enrolled up to 1. June 2010 959 patients with a total of 1019 implanted grafts. Of these 59 patients died (overall 12-month mortality of 6.4%), 35 lost their organ and 81 lost their organ or died. The excellent work of the local organization with local data managers and transplant physicians led to only three patients lost to follow-up. Overall 95% of patients consented to the STCS and 93% have provided bio-sample material. We hope to increase these figures with increasing experience.The Scientific Committee held its first constitutive meeting in November 2008. Representatives of all centers, transplant programs and sub-specialties have since evaluated 12 projects and accepted 10, covering a wide scope from psychosocial themes to basic immunology.During the next 3 years (2011-2013), the STCS will be consolidated and STCS-approved scientific projects (e.g. nested projects) will be implemented and completed. Due to the high complexity of the transplant environment, a core scientific infrastructure will be put into place to assist scientists to plan, conduct and analyze projects nested in the STCS. The next funding period will also focus on systematic monitoring and improvement of data quality, and into developing international collaborations. Future developments will also include an upgrade of the IT system, ensuring longitudinal consistency of the data, enhancing data management and improve reporting.The STCS can become a model for high-quality clinical transplant research in a national multicenter collaborative network, associated with improved patient-care and better cost-efficiency of the transplant process. The STCS will also evolve as tool for monitoring quality of care and it may assist official policy-making in the future.
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