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A gem of transplantation medicine turns 30

The Heidelberg Collaborative Transplant Study evaluates data on approx. 500,000 transplantations worldwide / Scientific basis for organ allocation and transplant treatment

Heidelberger Collaborative Transplant Study (CTS) 1982-2011

Transplants With Follow UP


Initiates file download[graphic in print resolution]


The world’s largest study in the area of transplantation medicine is turning 30. Since 1982, Prof. Gerhard Opelz and his team at the Department of Transplantation Immunology at Heidelberg University Hospital’s Institute for Immunology have collected and evaluated data on more than 500,000 transplants in around 500 hospitals in 43 countries. The Collaborative Transplant Study (CTS) has demonstrated how important immunological characteristics – the HLA antigens – are for the success of a kidney transplant and how effective, but also how toxic, immunosuppressant drugs can be. The CTS data also serve as the scientific basis for allocating organs by Eurotransplant.

“Tens of thousands of patients all over the world have benefited from this study,” explained Prof. Markus Büchler, head of the Transplant Center at Heidelberg University Hospital. The wealth of data allows statistically reliable statements to be made that directly benefit proper organ allocation and scientifically based treatment of the patients.

Fourteen publications in The Lancet and The New England Journal of Medicine

“The study’s significance is evidenced by the high number of journal articles, with 14 of them alone in the top clinical journals The New England Journal of Medicine and The Lancet,” said Prof. Stefan Meuer, Director of Heidelberg University Hospital’s Institute for Immunology.

The starting point of the study was the finding that certain surface proteins on donor organs activate the recipient’s immune defense, which can trigger the rejection of the organ. But which of these HLA antigens are key? And should the organs be allocated on this basis? “We provide reagents to transplant centers which they use to test organ recipients for their HLA antigens.” In return, the centers have provided the institute in Heidelberg with data on transplant results over a period of decades. This allows conclusions to be drawn about the significance of HLA antigen ´matching´ and of the efficacy and side effects of drugs used for immunosuppression.

Exact immunological match is key factor for kidney transplantation

Findings of the CTS include the following:

  • The immunological match plays a key role in the success of kidney transplantation. For this reason, a great deal of attention is paid to this factor when the kidneys are assigned to a recipient. For liver and pancreas transplants, an exact match is less influential. While heart and lung patients would profit from matching as well, urgency is the major criterion for allocating these organs.

  • Certain drugs, including cyclosporine and tacrolimus, can considerably boost the success rate of transplantation. However, depending on the dosage, the risk of developing cancer is significantly greater. Transplant patients with better HLA compatibility require lower doses of immunosuppressive medication. Better HLA matching therefore not only improves the graft survival rate but in addition reduces the side effects of immunosuppressive treatment, such as the development of certain tumors, the occurrence of life-threatening infections and cardiovascular complications, and the occurrence of post-transplant bone fractures.

To date, the study has been financed by donors from the IT and transplant sectors and through the proceeds from the reagents sent to transplant centers for testing the HLA antigens. “Scientific independence has been ensured at all times,” said Prof. Opelz. This gem of transplantation medicine will be continued after Prof. Opelz retires in two years. At present, sponsors are being sought who wish to contribute to preserving the world’s largest transplant data registry, the Collaborative Transplant Study.


Heidelberger Collaborative Transplant Study (CTS) 1982-2011

% Graft survival / years


Initiates file download[graphic in print resolution]

For more information, go to:
Opens external link in new windowwww.ctstransplant.org

Prof. Dr. Gerhard Opelz
Medical Director, Department of Transplantation Immunology
Tel.: 0049 6221 56-4013
E-Mail: Opens window for sending emailgerhard.opelz@med.uni-heidelberg.de

Heidelberg University Hospital and Medical Faculty:
Internationally recognized patient care, research, and teaching 

Heidelberg University Hospital is one of the largest and most prestigious medical centers in Germany. The Medical Faculty of Heidelberg University belongs to the internationally most renowned biomedical research institutions in Europe. Both institutions have the common goal of developing new therapies and implementing them rapidly for patients. With about 11,000 employees, training and qualification is an important issue. Every year, around 550,000 patients are treated on an inpatient or outpatient basis in more than 50 clinics and departments with 2,000 beds. Currently, about 3,600 future physicians are studying in Heidelberg; the reform Heidelberg Curriculum Medicinale (HeiCuMed) is one of the top medical training programs in Germany.



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