Adult to Adult Living Donor Liver Transplantation

成人对成人活体供肝移植

• 批准号: 7391909
• 负责人: ROBERT A FISHER
• 金额: $ 4.3万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-17 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7391909
• 关键词: Adult; Age; Ancillary Study; Caring; Child; Cirrhosis; Cohort Studies; Communities; Control Groups; Etiology; Family; Gender; Health system; Hepatectomy; Hepatic; Histology; Individual; Infant; Life; Liver; Liver diseases; Living Donor Liver Transplantation; Living Donors; Medial; Medical; Morbidity - disease rate; Numbers; Operative Surgical Procedures; Organ; Outcome; Patients; Postoperative Period; Primary carcinoma of the liver cells; Procedures; Quality of life; Race; Reporting; Risk; Safety; Score; Severities; Staging; Time; Transplantation; Universities; Virginia; college; cost; experience; improved; interest; liver transplantation; mortality; psychologic; volunteer

Over the past decade a growing shortage of donated organs has greatly increased the number of patients who have developed complications of end-stage cirrhosis including hepatocellular carcinoma (HCC) and the mortality for patients awaiting liver transplantation (LT). Living donor liver transplantation (LDLT) was conceived as a way to increase the availability of donated organs and was initiated in infants and children more than a decade ago. Controlled trials demonstrated the safety and efficacy of this procedure. Recently, LDLT has been adapted for the adult. Since then patients, their families and the transplant community have embraced this procedure despite reports of donor morbidity, mortality and early reports that recipients may have increased post-operative complications and reduced survival compared to CADLT. The specific aims of the LDLT cohort study is to define the short and long term risks of morbidity and mortality forthe adult donorandto determine the efficacyofthis procedurefor the adult recipient comparedto patients undergoing LTwith acadavericliver (CADLT). Individuals interested inbecoming living donors will beaskedto participate in this study. Thosewho are selected and undergo the surgical procedure will be followed at periodic intervals to define the long term morbidity and mortality of the procedure. Individuals not selected as living donors will be matched to the actual donors 2:1 by age, race and gender and also followed prospectively as a donor control group. Individuals being evaluated for LTwill beasked if they would be interested inundergoing LDLT. Those patients who identify an acceptable donor and undergo LDLT will be followed prospectively at-periodicintervals to define the short and long term morbidity and mortality associatedwith this procedure. Those patients who are unable to identify a living donor will be matchedto an actual LDLT recipient 2:1 by age, race, gender, disease etiology and severity of liver disease (MELD score). These patients will actasthe recipient control group andwilland befollowed prospectively before and afterthey undergoCADLT. Ancillary studies accompanying the main trial will specifically evaluate the ability of LDLT to improve the long term outcome of patients with HCCand to evalaute the effects of donation and LDLT on hepatic histology.

在过去的十年里，捐赠器官的日益短缺大大增加了患者的数量， 发生包括肝细胞癌（HCC）在内的终末期肝硬化并发症， 等待肝移植（LT）。活体肝移植（LDLT）被认为是一种增加患者存活率的方法。 这是一项旨在提高捐赠器官可用性的计划，十多年前开始在婴儿和儿童中开展。对照试验 证明了该手术的安全性和有效性。最近，LDLT已适用于成人。此后 尽管有供体发病率的报道， 死亡率和早期报告称接受者可能会增加术后并发症和降低生存率 与CADLT相比。LDLT队列研究的具体目的是确定短期和长期发病风险 和死亡率，并确定与患者相比， 行肝移植术（CADLT）。有兴趣成为活体捐赠者的个人将被邀请参加 本研究将定期随访被选择并接受手术的患者，以确定 手术的长期发病率和死亡率。未被选为活体捐赠者的个人将与 按年龄、种族和性别以2：1的比例确定实际供体，并作为供体对照组进行前瞻性随访。的个体 评估LT时会询问他们是否有兴趣接受LDLT。那些确定可接受的 供体和接受LDLT的患者将每隔一段时间进行前瞻性随访，以确定短期和长期发病率 and mortality死亡associated关联with this procedure程序.那些无法确定活体捐赠者的患者将与 根据年龄、种族、性别、疾病病因和肝病严重程度（MELD评分），实际LDLT接受者为2：1。这些 患者将作为受体对照组，在接受CADLT前后进行前瞻性随访。 伴随主试验的辅助研究将专门评估LDLT改善长期 观察肝细胞癌患者的预后，并评估献血和LDLT对肝组织学的影响。