CTS Collaborative Transplant Study

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1 CTS Collaborative Transplant Study Newsletter : February, The year marks the th anniversary of the Collaborative Transplant Study. Credit goes to all participants for their contribution to a priceless and invaluable resource of transplant information. Much has been learned from our combined efforts during these years and it is likely that more valuable research findings will be made during coming years. The key feature of the CTS registry is its high quality, thanks to the excellent support by all of you. Whereas years ago the one-year graft survival rate was the accepted gauge for measuring the success of transplantation, attention has focused on long-term outcomes in recent years. CTS played a role in this development. As customary at the beginning of each year, we have updated all website graphs to include the most recent experience and to show comparisons between results obtained during early and more recent phases of this project. You are welcome to view the updated website graphs under: The new password is enclosed. Serum Creatinine Kidney Transplants Since % < µmol/l HLA-Id Sibling or Other or n=, n=, n=, Figure

2 CTS Newsletter : Page For the analysis of long-term outcomes, not only the graft survival rate but also the quality of graft function as well as secondary outcome indicators are of interest. As an example, the evolution of serum creatinine values as a reflection of graft function is shown for different categories of kidney transplants in Figure. With years of observation, the privileged category of transplants from HLA-identical sibling donors clearly outperforms other categories. Approximately - % more of these patients had a creatinine of < µmol/l throughout the follow up period. Whereas kidney function in liver transplant recipients is strikingly better than that in deceased-donor kidney recipients, kidney function in heart transplant recipients is very similar to that found in kidney recipients (Figure ). Whether these differences are simply a reflection of differences in immunosuppressive treatment with potentially nephrotoxic drugs remains to be elucidated. Serum Creatinine Transplantations Since ors Liver n=, % < µmol/l Kidney Heart n=, n=, Figure There are also interesting differences in the rates at which patients develop de-novo cataract or osteoporosis. We studied patients for whom a negative status for cataract and osteoporosis was reported at year one post-transplant. During the following years, liver recipients showed the lowest, heart recipients an intermediate, and deceased-donor kidney recipients the highest rate of cataract (Figure ). However, when significant evidence of osteoporosis was analyzed, heart recipients showed the highest rate (Figure ). While steroid treatment has been implicated as an important inducer of both diseases, the discrepant results shown in Figures and suggest that it is not simply a question of steroid dose whether a patient develops a cataract or osteoporosis.

3 CTS Newsletter : Page % Cataract De-Novo Cataract After Year Transplantations Since ors Kidney Heart Liver n=, n=, n=, Figure De-Novo Osteoporosis After Year Transplantations Since ors % Osteoporosis Heart Kidney Liver n=, n=, n=, Figure

4 CTS Newsletter : Page The results for de-novo cataract and osteoporosis in the different categories of kidney graft recipients are depicted in Figures and. Recipients of deceased-donor grafts show higher rates than recipients of grafts from live donors. De-Novo Cataract After Year Kidney Transplants Since % Cataract HLA-Id Sibling Other n=, n=, n=, Figure De-Novo Osteoporosis After Year Kidney Transplants Since % Osteoporosis Other HLA-Id Sibling n=, n=, n=, Figure

5 CTS Newsletter : Page One might suspect that differences in recipient age might explain the differences shown in Figures -. However, we found that the answer is not as simple as that (Figures and ) and that further analysis using sophisticated statistical techniques will be required for obtaining a better answer. % Cataract Age - yr De-Novo Cataract After Year Kidney Transplants Since Age - yr n=, n=, n=, n=, Figure % Osteoporosis Age - yr De-Novo Osteoporosis After Year Kidney Transplants Since Age - yr n=, n=, n=, n=, Figure

6 CTS Newsletter : Page I would like to remind you that the next deadline for shipment of material for the CTS serum and DNA projects is May /,. Please inform us per , fax or telephone of shipping details so that we may follow up from our end in case shipments are delayed. Do not hesitate to contact us if you have any questions. Your support of these studies is highly appreciated. Please be a part of this important initiative! It is not too late to join. Thank you for your continued cooperation. With best wishes for a successful year, Gerhard Opelz Prof. G. Opelz, Transplant Immunology, University of Heidelberg Im Neuenheimer Feld, D - Heidelberg, Germany Phone: +-- Fax: gerhard.opelz@med.uni-heidelberg.de Website: