Candidate Selection for Liver Transplantation in Patients with Alcohol-related Liver Disease

酒精相关性肝病患者肝移植候选者的选择

• 批准号: 10660978
• 负责人: Po-Hung (Victor) Chen
• 金额: $ 19.82万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10660978
• 关键词: Abstinence; Acute; Acute Alcoholic Hepatitis; Adrenal Cortex Hormones; Alcohol consumption; Alcoholic Hepatitis; Alcoholic Liver Diseases; Alcohols; Attenuated; Behavioral; Biological Markers; Biometry; Cessation of life; Chronic; Cirrhosis; Clinical Investigator; Cohort Studies; Collaborations; Communities; Consensus; Country; Data; Decision Making; Delphi Technique; Development; Development Plans; Electronics; Europe; Evaluation; Event; Fostering; Funding; Future; Goals; Graft Rejection; Hepatitis C; Hepatology; Inferior; Injury; Intervention; Interview; Knowledge; Liver diseases; Medical; Medicine; Multicenter Trials; National Institute on Alcohol Abuse and Alcoholism; Natural History; Outcome; Patients; Pilot Projects; Predictive Analytics; Process; Program Development; Protocols documentation; Questionnaires; Refractory; Relapse; Reproducibility; Research; Research Personnel; Research Training; Risk Estimate; Science; Scientist; Selection Criteria; Social support; Standardization; Surveys; Transplant Recipients; Transplantation; United States; Universities; Validation; Work; addiction; adverse outcome; alcohol abstinence; alcohol abuse therapy; alcohol relapse; alcohol research; alcohol screening; candidate selection; career development; cohort; empowerment; evidence base; experience; follow-up; improved; interdisciplinary approach; liver transplantation; member; mortality; mortality risk; non-alcoholic fatty liver disease; novel; post-transplant; predictive modeling; prolonged abstinence; relapse risk; risk prediction; skills; sobriety; substance use; supportive environment; tool; transplant centers

PROJECT SUMMARY Alcohol consumption is a major cause of liver disease worldwide. Severe alcoholic hepatitis (SAH), an acute manifestation of alcohol-related liver disease (ALD), is associated with inferior short-term survival. Unfortunately, there are few effective medical therapies for SAH outside of corticosteroids, to which about 40% of patients are refractory. For these patients, liver transplantation (LT) is the only rescue treatment available. Until recently, most transplant centers mandated at least six months of continuous abstinence from alcohol before LT. Unfortunately, this “6-month rule” was(is) often unachievable for patients with SAH, due to recent alcohol use and high short-term mortality. Several recent studies from Europe and the United States championed the concept of early liver transplantation (ELT) in this highly vulnerable patient cohort, though post-LT alcohol relapse remained a concern with adverse consequences like graft injury and cirrhosis. To date, there is no consensus on the optimal LT candidate selection criteria in ALD, which can lead to uneven and substandard post-LT outcomes, including alcohol relapse. This project will advance our field in several ways. First, it will define the impacts of ELT and alcohol abstinence on the natural history of SAH. Second, it will develop and validate a novel LT candidate selection tool in ALD. The project findings will support a planned multicenter trial and R01 submission for the external evaluation of the candidate selection tool. This proposed work represents an interdisciplinary approach toward the optimization and the standardization of the LT candidate selection process in ALD. To conduct this study, I will integrate myself into the research community of the NIAAA P50-funded Johns Hopkins DELTA Center for Alcohol Research, which will help me establish a network of alcohol researchers for current and future collaboration. I will also actively engage in formal coursework in biostatistics and addiction science as well as interdisciplinary career development programs. Through the proposed career development plan, I will gain the necessary skills and experience to establish myself as an independent clinical investigator bridging the fields of hepatology, transplantation, and addiction medicine.

项目总结

项目成果

Liver Transplant in Hemoglobin SC Disease and Autoimmune Hepatitis: A Case Report.

• DOI: 10.6002/ect.2021.0350
• 发表时间: 2022-04
• 期刊: EXPERIMENTAL AND CLINICAL TRANSPLANTATION
• 影响因子: 0.9
• 作者: Kim, Ahyoung;Assarzadegan, Naziheh;Anders, Robert A.;Oshima, Kiyoko;Chaturvedi, Shruti;Weeks, Sharon;Kohli, Ruhail;Lanzkron, Sophie;Gurakar, Ahmet;Garonzik-Wang, Jacqueline;Chen, Po-Hung
• 通讯作者: Chen, Po-Hung

Two Acute Liver Injuries in a Patient With Malnutrition.

• DOI: 10.14740/jmc3713
• 发表时间: 2021-08
• 期刊: Journal of medical cases
• 作者: Su A;Choe M;Birkness JE;Limketkai B;Chen PH
• 通讯作者: Chen PH

Clinical Considerations of Coagulopathy in Acute Liver Failure.

• DOI: 10.14218/jcth.2020.00058
• 发表时间: 2020-12-28
• 期刊: Journal of clinical and translational hepatology
• 影响因子: 3.6
• 作者: Kim A;Niu B;Woreta T;Chen PH
• 通讯作者: Chen PH

Provider Attitudes and Practices for Alcohol Screening, Treatment, and Education in Patients With Liver Disease: A Survey From the American Association for the Study of Liver Diseases Alcohol-Associated Liver Disease Special Interest Group.

• DOI: 10.1016/j.cgh.2020.10.026
• 发表时间: 2021-11
• 期刊: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
• 作者: Im GY;Mellinger JL;Winters A;Aby ES;Lominadze Z;Rice J;Lucey MR;Arab JP;Goel A;Jophlin LL;Sherman CB;Parker R;Chen PH;Devuni D;Sidhu S;Dunn W;Szabo G;Singal AK;Shah VH
• 通讯作者: Shah VH

Burden of Crohn's Disease in the United States Medicaid Population, 2010-2019.

2010-2019 年美国医疗补助人群的克罗恩病负担。

• DOI: 10.1016/j.cgh.2023.05.002
• 发表时间: 2024
• 期刊: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
• 作者: Hutfless,Susan;Jasper,RyanA;Chen,Po-Hung;Joseph,Shelly;Miller,Steve;Brant,StevenR
• 通讯作者: Brant,StevenR