Adult to Adult Living Donor Liver Transplantation Cohort Study

成人至成人活体肝移植队列研究

基本信息

  • 批准号:
    8145312
  • 负责人:
  • 金额:
    $ 25万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2002
  • 资助国家:
    美国
  • 起止时间:
    2002-09-01 至 2014-08-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): The A2ALL consortium was chartered in 2002 and has collected data on a large cohort of donor and recipient candidates for LDLT spanning over a decade of activity in 9 US centers. Dr. Emond has been a Co-chair of A2ALL and a member of the Project Executive Committee since the onset of the study and led the development of the cohort protocol. The consortium has contributed important publications defining the benefit of choosing living donation, and the outcomes and complications of the donor and recipient procedure. Descriptive studies from the retrospective cohort have defined the donor evaluation, and illuminated important issues on hepatitis C, HCC, and rejection in recipients of LDLT. A2ALL remains positioned to address critical biological questions related to hepatic inflammation, regeneration, and carcinogenesis in the recipient. A novel and important interventional trial of pre-transplant treatment of HCV in LDLT candidates is underway. Equally important is to study donor liver function and regeneration as well as to define the long-term medical and psychological consequences of liver donation. Columbia has contributed substantially to the overall accrual of A2ALL includes 239 subjects in retro, 17 subjects in bridge and 270 in A2ALL cohort. Clinical outcomes are excellent with a one year recipient survival of 95.3% of adults. In this application for renewal, we commit to continued follow-up of our donors and recipients and further accrual of subjects to achieve the goals of the consortium as defined in the RFA. We describe numerous organizational and technologic improvements in our center, including dedicated staff and an electronic record system to optimize data collection and follow-up. Though A2ALL has made great progress in description of LDLT and defining the outcomes, we have fallen short in two critical areas, understanding of the donor experience and development of surgical innovations to reduce the donor operation without compromising recipient outcomes. These related issues are central to making the case for expansion of LDLT in adults. No matter how good the results of LDLT, there will be no impact if it is not used. To this end we introduce two research proposals that are complementary and enhance the overall aims of A2ALL. First, a structured study of the psychiatric complications in living donors including developing predictors and determining using a control population of concurrently enrolled laparoscopic renal donors whether more limited hepatectomy will improve psychological health of donors. Second, a pilot protocol of using smaller left lobe grafts with appropriate biological and technical manipulations PUBLIC HEALTH RELEVANCE: There remains a major shortage of donors for the nearly 16000 patients waiting for liver transplantation (OLT). Living donor liver transplantation (LDLT) has offered an alternative source of organs but was used in only 178 of 5705 adults (3.1%) receiving OLT in the US in 2008. We propose to increase the use of LDLT by interventions which decrease the extent of the donor hepatectomy, increasing donor safety
描述(由申请人提供):A2ALL联盟于2002年特许成立,并在9个美国中心收集了大量LDLT供体和受体候选人的数据,这些数据跨越了十多年的活动。自研究开始以来,Emond博士一直是A2ALL的联合主席和项目执行委员会成员,并领导了队列方案的制定。该联盟贡献了重要的出版物,定义了选择活体捐赠的好处,以及捐赠者和接受者程序的结果和并发症。回顾性队列的描述性研究定义了供体评估,并阐明了LDLT受者中丙型肝炎、HCC和排斥反应的重要问题。A2ALL仍然定位于解决与受体肝脏炎症、再生和癌变相关的关键生物学问题。一项在LDLT候选者中进行移植前HCV治疗的新的重要干预性试验正在进行中。同样重要的是研究供体肝功能和再生,以及确定肝脏捐赠的长期医疗和心理后果。哥伦比亚对A2 ALL的总体累积贡献很大,包括239例回顾性受试者、17例桥接受试者和270例A2 ALL队列受试者。临床结果非常好,一年的受体存活率为95.3%。在本次更新申请中,我们承诺继续随访我们的捐赠者和接受者,并进一步增加受试者,以实现RFA中定义的联盟目标。我们描述了我们中心的许多组织和技术改进,包括专门的工作人员和电子记录系统,以优化数据收集和跟踪。虽然A2ALL在描述LDLT和定义结局方面取得了很大进展,但我们在两个关键领域仍存在不足,即对供体经验的理解和手术创新的发展,以减少供体手术而不影响受体结局。这些相关的问题是使LDLT在成人中扩展的核心。无论LDLT的效果有多好,如果不使用,也不会有任何影响。为此,我们介绍了两个研究建议,是互补的,并加强A2ALL的总体目标。首先,一个结构化的研究,精神并发症的活体捐赠者,包括开发预测因子,并确定使用控制人口的同时登记腹腔镜肾捐赠者是否更有限的肝切除术将改善捐赠者的心理健康。第二,一个试点协议,使用较小的左叶移植物与适当的生物和技术操作 公共卫生相关性:对于近16000名等待肝移植(奥尔特)的患者来说,供体仍然严重短缺。活体肝移植(LDLT)提供了一种替代的器官来源,但2008年在美国接受奥尔特的5705名成人中仅178人(3.1%)使用。我们建议通过减少供体肝切除范围的干预措施来增加LDLT的使用,增加供体的安全性

项目成果

期刊论文数量(0)
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科研奖励数量(0)
会议论文数量(0)
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JEAN C EMOND其他文献

JEAN C EMOND的其他文献

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{{ truncateString('JEAN C EMOND', 18)}}的其他基金

Adult to Adult Living Donor Liver Transplantation Cohort Study
成人至成人活体肝移植队列研究
  • 批准号:
    8016207
  • 财政年份:
    2010
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    6945824
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohort Study
成人至成人活体肝移植队列研究
  • 批准号:
    8898944
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    6803440
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    7121127
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    6651061
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohort Study
成人至成人活体肝移植队列研究
  • 批准号:
    8131421
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    7276277
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohor*
成人对成人活体肝移植队列*
  • 批准号:
    6549052
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:
Adult to Adult Living Donor Liver Transplantation Cohort Study
成人至成人活体肝移植队列研究
  • 批准号:
    7792640
  • 财政年份:
    2002
  • 资助金额:
    $ 25万
  • 项目类别:

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