Patient Population

This multicenter cohort study used data from two prospective European LT cohorts, the French–Belgian Cohort of LT (COLT) and the Swiss Transplant Cohort Study (STCS). COLT includes 11 French centers (Bordeaux, Grenoble, Lyon, Marseille, Nantes, Georges Pompidou Hospital, Hospital Bichat in Paris, Centre Chirurgical Marie Lennelongue in Le Plessis-Robinson, Strasbourg, Toulouse, Foch Hospital in Suresnes) and the Erasme center in Brussels, Belgium. It was established in October 2009. STCS is a multicenter cohort collecting data from all Swiss transplant programs (23, 24). The two Swiss LT centers, Zurich and Lausanne/Geneva, participate in STCS since its establishment in April 2008.

COLT and STCS patients were eligible for the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. Only patients with a first LT were included in the study. Data collection concerned the periods between October 2009 (for COLT) or April 2008 (for STCS) and February 2014 (for both cohorts). Data harmonization, completion, and quality control were performed during the following 1.5 years. The corresponding national and local ethics committees approved the study protocol, and all participants provided written informed consent.