Continuing Retrospective/Prospective Studies Based on Clinical Observation

这个项目由49个子项目组成，每个子项目都包含一个关于我们全面的计算机化临床数据存储和检索系统的单独问题。我们收集了自1968年以来在明尼苏达大学进行的5700多例肾脏移植的数据，以及自1984年以来3600名移植患者的非常全面的信息。多个细节(术前风险因素；组织分型；移植入院和手术；供者信息；移植后再次入院、排斥、活组织检查、感染和其他并发症；生活质量、康复)可用。新的移植是前瞻性的；此外，我们正在将1984年前移植的患者添加到这个数据库中。计划进行两种类型的研究--回顾研究和前瞻性研究。在其中一些次级项目中，数据收集工作已经完成，并计划进行分析。在另一些人中，长期随访 是必需的。我们的计算机数据库使我们能够研究移植风险因素，达到以前不可能达到的程度。该计算机允许对患者亚组的微型系列进行分析和/或对风险因素的重要性进行多变量分析。其中最重要的子项目是：A.“高凝状态”对移植物丢失的影响；D.C4D染色是否有助于解释移植肾活检？；G.与受者风险因素有关的结局；J.移植失败的受者的结局如何最大化？R.当前受者的长期结局是否有所改善？T.皮肤癌；W.定义缓慢的移植物功能；W.骨骼疾病和心血管疾病之间的关系；x.正在进行的非定向捐献研究；ii.糖尿病和非糖尿病受者的风险因素。

This project consists of 49 subprojects, each of which comprises a separate question to be asked of our comprehensive computerized clinical data storage and retrieval systems. We have collected data on more than 5,700 kidney transplants performed at the University of Minnesota since 1968, and very comprehensive information on 3,600 patients transplanted since 1984. Multiple details (preoperative risk factors; tissue typing; the transplant admission and surgery; donor information; post transplant readmissions, rejections, biopsies, infections, and other complications; quality of life, rehabilitation) are available. New transplantas are entered prospectively; in addition, we are adding patients transplanted prior to 1984 into this database. Two types of studies are planned--retrospective and prospective. In some of these subprojects, data collection has been completed and analysis is planned. In others, long-term follow-up is required. Our computer database permits us to study transplant risk factors to an extent that has not previously been possible. The computer allows analysis of mini-series of subgroups of patients and/or multivariate analysis of the importance of risk factors. Among the most important of the subprojects are: A. Impact of "hypercoagulability" on graft loss; D. Is C4d staining helpful in interpreting renal allograft biopsies?; G. Outcome in relation to recipient risk factors; J. How can outcome be maximized for recipients with failing grafts?; R. Is long-term outcome improving for current recipients?; T. Skin cancer; U. Defining slow graft function; W. Relationship between bone disease and cardiovascular disease; X. Ongoing studies on nondirected donation; II. Risk factors in diabetic and non-diabetic recipients.