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Presentation
The network and its partners
History of transplantation  |
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1st European validated data bank for transplantation
UP TO NOW
Ten years ago, no data bank in transplantation could allow to carry out precise epidemiological studies of high quality in transplantation. The French Graft Institution Registry and the CTS (Collaborative Transplant Study) data bank headed by Pr. G. Opelz in Heidelberg (Germany) could only provide few and non-validated data. In order to meet this transplantation epidemiological need, the DIVAT data bank has been created. DIVAT allows an interractive collection of more than 200 biological and medical parameters for patients who have been transplanted with a kidney and/or pancreas since 1990. In the first place, the data bank was located in the Nantes' Hospital. Then quicky, a french network has been created including Necker Hospital (Paris) and Hospitals in Nancy, Montpellier and Toulouse (more than 100 kidney grafts) and more recently Lyon Hospital. DIVAT is supported by IDBC company (created together by the ITERT in 2000) and beneficiates from favored relashionships with Roche Laboratory. Data quality of the DIVAT bank is validated for it undergoes annual cross audit, addressingthe data sources as well as the data recorded by each centre. DIVAT Data bank has become a very usefull epidemiological tool in transplantation. Because of the cohort increasing dimension, patients with kidney and/or pancreas transplants, in DIVAT, we wished, in addition to the epidemiological tool, to create an biological collection bank, which would allow us to develop translational research with the U643 Unit (INSERM). This is why the Biological collection DIVAT-Biocol (tender for Inserm biological collection # 02 G 0555) has been created. It allows the storage of blood sample, mRNA and urine samples of Nantes transplanted patients. Samples are directly linked to clinical data of the DIVAT data bank. We would like now to include the Necker and Lyon hospitals in this biocollection within the CENTAURE Network DIVAT aim. DIVAT is becoming a methodological standard and thus almost all of grafts on kids in france have been included in the DIVAT-Pédiatrie national network (coordinated by Dr. Guyot, pediatrician in Nantes hospital).
in the future
DIVAT is now coupled to a tool of descriptive statistics which enable us to develop studies on the becoming of transplanted patients. However, a more powerful statistical access involving professional statisticians specifically assigned to the analysis of data of the bank, appeared essential for the realization of complex statistical models (even innovative ones) in the field of transplantation. This is why we created a 'statistical structure' dedicated to graft epidemiologic work within the framework of the DIVAT data base. A PhD student in biostatistics, from the Laboratory Epidemiology and Biostatistics of Montpellier, headed by Pr. JP. Daurès, has been hired thanks to the CENTAURE Network. We have described the first semi-Markov model dedicated to renal transplantation (FoucherY, Giral M, Soulillou JP, Daures JP. Stat med. Nov 2007). We wish to keep on studying this subject in order to define innovative epidemiological models in transplantation. For instance, we would like to create ROC score with a covariate at one year before and after transplantation, which would be predictive for graft loss at 5 and 10 years post-transplantation. A phD student will be welcomed in May 2008 and he will help in working on this clinical research.
Because of the transplanted biocollectionis an unrivalled tool and could allow to develop studies on translational research with the help of the CENTAURE Netword's researchers, we would like to develop and structure Biological Ressource Center, DIVAT-Biocol. The creation of this Center is now a priority to be developped in the frame ot the Centaure Network. In this respect, ITERT and the Thorax Institute of Nantes have decided to pull together compliance of both collections under the sole name of «la Biobanque Ouest Atlantique». A quality engineer has been recruited (Sonia Brémard) for 18 monthss. Moreover, in order to make our biocollection durable and to extend it to Necker and Lyon hospitals, a part-time technician has been recruited. He will help in running our biocollection in addition to two hospital technicians.
We wish to extend our DIVAT data bank to other European transplantation centers. At present, there is no European validated data bank for renal transplantation. This is why we think there is a real need for a European data bank creation, including specific parameters for the following up of transplanted with kidney and according to the initial methodology of DIVAT. Centers wishing to enter this European bank will be co-opted. The network extension to the Pise hospital (Italy) and Bruxels hospital (Belgium) is under development.
The DIVAT-Pancreas project is part of the DIVAT extension and is also supported by the CENTAURE Network. Centaure core centers of Nantes and Lyon represents 65% of pancreas transplants performed in France. We would like to create a unique data bank regarding medical and surgical parameters for pancreas transplants peformed in Nantes and Lyon (and potentially Pisa center). Our goal is to structure this new data base alternatively under the coordination Nantes, Lyon or Pisa (respectively Diego Cantarovich and Lionel Badet and F. Vistolli, current post-PhD student in ITERT: 2007-2009). We will then create an epidemiological tool on pancreas transplant allowing us to study more than 700 patients with a pancreas transplant, which is denied by any registry. Data base is under construction.
