September 1, 2001
The new CTS database software package TaXi was requested by more than 150 transplant centers. It will be delivered together with this newsletter, by separate mail.
To recapitulate, the database will allow you to maintain up-to-date records of your own transplants. The data can be easily exported, which will enable you to perform analyses for your yearly center statistics using Excel or other standard software. Your data can be conveniently reported to CTS using an encrypted data transfer mode, which is included in the package. Kaplan Meier survival curves can be generated for your own center's transplants using the CTS website analysis function. On your own request, your data can be forwarded by us to national or international registries.
Simultaneous with the release of the TaXi database, we are activating a special homepage which is dedicated to the support of TaXi users (www.ctstransplant.org/taxi). You can retrieve instructions as well as useful hints from this website. A special e-mail address is provided for communication with our computer staff (taxi.cts@med.uni-heidelberg.de).
The most demanding function of the new software is probably that which allows you to define special variables which are of particular research interest to your center. Please follow the instructions carefully. Our staff is prepared to assist you in any way possible.
As already announced in the previous newsletter, you can choose to enter both initial registrations as well as clinical follow up data via TaXi, or you may opt for reporting one of the two parts using hard copy format and the second via TaXi. However, it will be necessary for you to decide on a specific strategy for reporting your data. It will definitely not be possible to report some transplants on the yellow CTS forms and to enter others directly on the computer. Likewise, clinical updating will have to be done either using hard copy format or electronically. Should you decide against reporting both parts using TaXi, please contact our staff and indicate the method in which you would like to do your reporting.
You should not expect that entering your data on your own terminal will require less effort. The advantage of using TaXi will be that you will have complete control over a local database containing your up-to-date transplant data. This will allow for maximal flexibility and for access at any time to a current database of your center's transplants.
Although the TaXi program has been extensively tested, we expect that some problems will occur and that some modifications will become necessary. The TaXi website will serve to inform all users about new developments and it will provide instructions for downloading of future TaXi releases. We are counting on your patience and cooperation to make this new database a success.
As you know, the CTS website contains a section which lists e-mail addresses, telephone numbers, and fax numbers for transplant centers participating in CTS. Please take your time and check the content for your own center. We have received several notices of incorrect email addresses. Because the CTS website is a widely used resource for contact addresses, it is important that your address be kept up to date. Thank you in advance for your consideration in this matter.
The last shipping cycle for the DNA project resulted in the receipt of 2500 samples. Thanks are due to all those participants who are supporting this international research project. We are currently preparing another update of DNA results in order to show where each center stands in comparison to other CTS participants. Because our computing facility is in the process of moving to a new location, we had to postpone the reporting of DNA statistics and currently expect that they will become available in October. The next date for shipping of DNA material to Heidelberg is
Please provide samples from recipients and donors of kidney, heart, and liver transplants. At this time, we will be particularly grateful for samples from liver grafts, since we have obtained very interesting preliminary results which need to be confirmed before any data are released. If you require information concerning the preparation and shipment of material for the DNA study, please do not hesitate to contact us.
With constantly improving methods of immunosuppression, it is legitimate to ask whether HLA matching in kidney transplantation still exerts a significant effect on graft outcome. If the survival rate of poorly matched grafts had improved to that of matched ones, one could justifiably argue for the abandonment of HLA typing and matching. For that reason, we performed an analysis in transplant recipients who were treated with "modern" immunosuppression, including the drugs Cyclosporine-Neoral, Tacrolimus (FK 506), Cell Cept (MMF), Sirolimus (Rapamycin), or IL2-receptor antibodies, in any combination. Transplants performed from 1995 to 1999 were analyzed. The results shown in Figure 1 clearly indicate that HLA matching continues to be important and that efforts at better matching therefore continue to be worthwhile.
A comparison to transplants performed from 1990 to 1994 in patients treated with the conventional cyclosporine formulation shows a somewhat different picture of the HLA effect (Figure 2).
Apparently, acute rejections during the first posttransplant year have decreased thanks to the improved action of new immunosuppressants. However, at 4 years posttransplant, the difference between perfectly matched and completely mismatched grafts is nearly the same in the two datasets and highly statistically significant (p<0.0001).
The database for analysis of your own centerīs results via the CTS website has been updated so that you can obtain graphics and statistics based on the most current data. We will update and expand the graphics section showing the overall CTS results in time for the December 1, 2001, website release. Therefore, we would be grateful to you for returning all follow up data by November 15, at the latest. The current password will remain functional until December 1.
Please give us your feedback on the use of the new TaXi software package. If you notice any inadequacies, we will do our best to improve the program. We also ask for your understanding: since we are not a professional software house, this ambitious new development may require a little patience. You can rest assured, however, that we are determined to provide you with a fully functional and flexible transplant database.
Thank you very much for your continued support and cooperation.
Sincerely yours,