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Swiss Transplant Cohort Study

English title Swiss Transplant Cohort Study
Applicant Steiger Jürg Ulrich
Number 177522
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 01.02.2018 - 30.06.2021
Approved amount 5'125'000.00
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All Disciplines (19)

Discipline
Clinical Immunology and Immunopathology
Immunology, Immunopathology
Metabolic Disorders
Internal Medicine
Public Health and Health Services
Medico-Social Problems of the Elderly
Methods of Epidemiology and Preventive Medicine
Biomedical Engineering
Infectious Diseases
Cancer
Clinical Cardiovascular Research
Respiratory Diseases
Clinical Cancer Research
Occupational Medicine, Ergonomy
Clinical Pharmacology
Mental Disorders, Psychosomatic Diseases
Clinical Endocrinology
Dermatology
Surgery

Keywords (21)

Heart transplantation; Small bowel transplantation; Health services research; Patient reported outcomes (PRO); Transplant infectious diseases; Personalized health; Immunosuppression; Genomics; Transplant immunology; Pancreas transplantation; Hematopoietic stem cell transplantation; Oncology; Kidney transplantation; Quality of life; Islets transplantation; Lung transplantation; Epidemiology; Graft survival; Liver transplantation; Psychosocial factors; Biomarker

Lay Summary (German)

Lead
Oft ist eine Organtransplantation die letzte Möglichkeit, Patienten mit Organversagen zu helfen. Trotz Fortschritt stellt sie für Patienten und Ärzte eine grosse Herausforderung dar. Das Wissen über das komplexe Zusammenspiel von Risiko-und Erfolgsfaktoren ist entscheidend für die Patientenversorgung und für die Weiterentwicklung der Transplantationsmedizin.
Lay summary

Inhalt und Ziel des Forschungsprojektes

Im Jahre 2007 haben Forscher die Swiss Transplant Cohort Study (STCS) mit dem Ziel gegründet, die Langzeitresultate in der Schweiz durchgeführter Organtransplantationen sowie die langfristigen Effekte der Immunsuppression zu untersuchen. Insbesondere gilt das Interesse der Transplantationsimmunologie, transplantationsbedingten Infektionskrankheiten, dem Genom, psychosozialen Faktoren, dem Auftreten von Tumoren sowie der Outcome-Forschung der verschiedenen Transplantationsprogramme. Bis Ende Juni 2017 konnten 4261 Transplantatempfänger erfasst und mehr als 3500 Patienten aktiv nachbeobachtet werden. Studien der STCS konnten zeigen, dass die Versorgungsqualität in den Schweizer Transplantationszentren ausgezeichnet ist: die Überlebensraten sind im internationalen Vergleich gleich gut oder besser. Zudem beherbergt die STCS über 110 Forschungsprojekte.

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojektes

In der Schweiz werden jährlich in 6 Zentren bis zu 400 Transplantationen durchgeführt. Die STCS gilt heute als die zentrale Forschungsplattform in der hochspezialisierten Transplantationsmedizin. Der Schlüssel ist, dass führende Experten aus verschiedenen Disziplinen intensiv zusammenarbeiten und dass nationale und internationale Forschergruppen qualitativ hochwertige Daten und Proben zur Verfügung haben. Das öffentliche Reporting macht die Behandlungserfolge transparent. Die Herausforderungen für die Zukunft sind, Patienten stärker einzubeziehen und das Datenmodell in Richtung einer Interoperabilitätsplattform zu entwickeln, um den Herausforderungen der Digitalisierung gerecht zu werden. 

Direct link to Lay Summary Last update: 30.01.2018

Lay Summary (French)

Lead
Pour aider les patients atteints d'insuffisance terminale d’organes, la transplantation est souvent le dernier recours. En dépit des progrès dans le domaine, cela reste toujours un défi majeur aussi bien pour les patients que pour les médecins. Il est donc crucial d’approfondir la connaissances des facteurs de risque et de succès pour améliorer la prise en charge des patients et contribuer au développement dans le domaine de la médecine de transplantation.
Lay summary

Contenu et objectif du projet de recherche

En 2007, des chercheurs suisses ont fondé l’Etude de Cohorte Suisse (STCS) dans le but d'analyser les résultats à long terme des transplantations d'organes réalisées en Suisse et d’étudier les effets à long terme de l'immunosuppression. Une attention particulière est portée aux domaines de l'immunologie de la transplantation, aux maladies infectieuses, au génome, aux facteurs psychosociaux, à l'incidence des tumeurs et aux résultats des différents programmes de transplantation.

À la fin du mois de juin 2017, 4261 receveurs de greffe avaient été enregistrés et plus de 3500 patients sont suivis. Grace à la STCS ont montré que la qualité des soins est excellente en Suisse: les taux de survie sont les mêmes ou meilleurs que ceux publiés au niveau international. D’autre part la STCS est scientifiquement très active et a généré plus de 110 projets.

Contexte scientifique et social du projet de recherche

En Suisse environ 400 transplantations sont réalisées chaque année dans les 6 centres de transplantation. Actuellement, la STCS est considérée comme la plateforme de recherche centrale de la médecine hautement spécialisée de la transplantation. Ceci est dû au fait que des experts de différentes disciplines travaillent ensemble de manière synergique et que les groupes de recherche nationaux et internationaux disposent de données et d'échantillons de haute qualité. Les rapports d’activité sont rendus publics ce qui renforce l’adhésion des patients à l’étude. Les objectifs pour le futur sont d'engager davantage les patients dans la recherche et de développer un modèle de données compatibles et intégrables dans une plateforme d'interopérabilité pour relever les défis de la numérisation.

Direct link to Lay Summary Last update: 30.01.2018

Responsible applicant and co-applicants

Employees

Associated projects

Number Title Start Funding scheme
192616 Immunogenetics of Viral Infections - Focus on human herpes simplex virus I 01.04.2020 Project funding (special)
173545 Reducing the Burden of Influenza after Solid-Organ Transplantation: the STOP-FLU trial [Swiss Trial in Solid Organ Transplantation on Prevention of influenza] 01.06.2017 Investigator Initiated Clinical Trials (IICT)
148512 Swiss Transplant Cohort Study 01.02.2014 Cohort Studies Large
163369 Susceptibility for cutaneous squamous cell carcinoma in organ transplant recipients 01.01.2016 Project funding (special)
159523 Pseudomonas aeruginosa in lung transplant recipients: adaptation and competition in the new host environment 01.06.2015 Project funding (special)
201385 The Swiss Transplant Cohort Study (STCS) 01.07.2021 Cohort Studies Large

Abstract

The Swiss Transplant Cohort Study (STCS) is a prospective open multicentre cohort study of all solid organ transplant (SOT) recipients in Switzerland. The project was initiated in 2007 and started to actively enrol patients in May 2008. The project has been funded, among others, by the SNSF as the core funding agency and currently stays in its 4th funding period. The STCS has evolved into the key tool of transplantation outcome research in Switzerland and has gained rapid international recognition due to the high granularity of data and systematic sampling, resulting in a remarkable scientific output. The key strength that made the STCS a prominent research platform is that the leading national experts from various disciplines collaborate under one roof. Over the last years, the number of scientific projects conducted within the STCS network was continuously increasing, with the 100th project approved by the STCS Scientific committee in 2016. Currently, 41 publications appeared in peer-reviewed scientific journals. Transplant infectious diseases continued to be one of the key areas of interest with a particular track record of critical issues in CMV infections. New areas have emerged, such as airway microbiome assessments in lung transplant recipients, T-cell response studies of BK virus infections in renal transplant recipients or genetic host factors of various infectious diseases phenotypes. Since 2012, the STCS collects antibiotic drug resistance data and first results are expected in 2017. Also recently, the genetic dataset has been enlarged to 3000 patients with genome-wide data and 10 published genetic studies of various phenotypes. The Psychosocial Interest Group (PISG) presented novel studies on body weight evolution, the influence of drug adherence and on workability after renal transplantation. Multiple national and international partners collaborate with the STCS for knowledge- and data exchange, resulting in high-ranked publications. A new level will be achieved with the inter-cohort collaboration with the Danish Persimune cohort and the creation of a metacohort with a common research portfolio. The backbone of the STCS is the unique data structure that allows reflecting every transplant type and the monitoring of even more complicated follow-up scenarios. The data involves clinical -, organ-specific -, laboratory -, psychosocial and behavioural -, genetic and infectious disease contents prospectively collected on a long-term schedule. In parallel, bio-banking of plasma, cell and DNA samples takes place at 0 - 6 - 12 months. Moreover, the STCS is legally mandated to keep a limited-registry of non-consenting patients. By the end of 2016, the STCS centres enrolled 4023 patients with 4187 transplantations, and a total of 4392 transplanted organs. During a maximum follow-up of nearly 9 years, 545 patients died (13.5%) and only 42 patients were lost to follow-up (1%). 93% of all Swiss transplant recipients provided written informed consent to the full STCS datasets, and 99% of consenting patients contributed to the STCS bio-bank. The STCS publishes comprehensive reports for the public and key federal institutions, such as the Federal Office of Public Health, UniMedSuisse and the Swiss Highly Specialized Medicine Board. In 2017, clinical transplant experts conducted in-depth reviews of all datasets and defined the necessary adaptations for the next upgrade (STCS generation 3). Furthermore the genetic working group was created to coordinate funding of extended genotyping and regulate the further use of genetic data. By May 2017, 76 persons were working for the STCS corresponding to 23.8 full-time equivalents being financed by SNF, third party, and own funds. For the next funding period, the STCS will face a number of significant challenges. Patients will be involved more closely to specify their needs and integrate their priorities. In addition to the two randomized trials ongoing and in preparation, additional trials are planned to improve the management of infectious complications post-transplant. The immunological datasets need an update to enable high-quality immunological studies. The current data model will expend towards an interoperability platform to link hospital routine care- and lab data from the centres using the standards proposed by the Swiss Personalized Health Network (SPHN). Conclusion: At the end of four SNF funding periods, the STCS represents a transplant cohort with a patient volume largely above 4000, that experiences large international recognition and that serves a broad variety of clinical, translational, interventional, psychosocial, and health services research. The presented approach to expand the data model towards a data and interoperability platform will prepare the STCS to enter the personalized health area.
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