Adult to adult living donor liver transplantation cohor*

活体供肝移植作为选择性肝移植的一种治疗方案迅速被接受。 终末期肝病患者。在过去的5年里，LDLT从大约50到60 每年的病例增加到今年的近500例，占#年进行的所有肝移植的近10% 美国。虽然小系列患者的报告表明，从技术上讲，LDLT可以 在进行时问题相对较少，目前还没有评估这种方法的疗效的对照研究。 将手术与身体移植进行比较。有必要对LDLT进行仔细的评估，因为 这一手术对肝移植的潜在影响。LDLT队列研究是一项多中心研究 旨在衡量LDLT捐赠者和接受者结局的对照研究。有几个 最不发达国家研究队列研究将解决的重要问题。首先，直接比较两国的生存状况 与身体移植相比，接受LDLT的受者将成为可能。自选择LDLT以来 受者不同于身体移植，本研究的对照组必须慎重选择。 其次，LDLT可能通过减少移植前的等待时间而潜在地降低等待名单上的死亡率。 此外，有初步数据表明，患有丙型肝炎的LDLT接受者(这是最多的 LDLT的常见适应症)可能比身体移植的预后更差。这个 必须评估LDLT对供体的影响。根据定义，活体捐赠者是一个健康的人 在没有任何个人利益的情况下接受了一次大的腹部手术。目前关于这一问题的数据非常少 供体手术对供体生存和生活质量的影响。因此，迫切需要 确定与LDLT相关的供者死亡率和发病率。最后，LDLT队列研究 提供了一个机会，直接为身体移植的LDLT总成本。完成后， 在LDLT队列研究中，医学界将更清楚地了解这一影响 肝移植的重要程序，供肝移植受者和供者。

Living donor liver transplantation has rapidly gained acceptance as a treatment option for selected patients with end-stage liver disease. Over the past 5 years, LDLT has grown from approximately 50 - 60 cases per year to nearly 500 cases this year, accounting for nearly 10 % of all liver transplants performed in the United States. While reports of small series of patients have demonstrated that LDLT can be technically performed with relatively few problems, there have been no controlled studies evaluating the efficacy of this procedure compared to cadaveric transplantation. A careful evaluation of LDLT is necessary because of the potential impact of this procedure on liver transplantation. The LDLT Cohort Study is a multi-center controlled study designed to measure the outcomes of donors and recipients of LDLT. There are several important issues which the LDLT Cohort Study will address. First, a direct comparison of survival of recipients of LDLT compared to cadaveric transplantation will be made. Since selection of the LDLT recipient is different than cadaveric transplantation, the control group for this study must be carefully chosen. Second, LDLT may potentially reduce waiting list mortality by reducing waiting time prior to transplantation. In addition, there is preliminary data which suggests that LDLT recipients with hepatitis C (which is the most common indication for LDLT) may have a worse outcome compared to their cadaveric counterparts. The impact of LDLT on the donor must be evaluated. The live donor is by definition a healthy individual who undergoes a major abdominal surgery for no personal benefit. There currently are very little data on the impact of this donor surgery on the donor's survival and quality of life. Therefore, it is imperative to determine donor mortality and morbidity rates associated with LDLT. Finally, the LDLT Cohort Study provides an opportunity to directly the total cost of LDLT with cadaveric transplantation. With completion of the LDLT Cohort Study, the medical community will have a much clearer understanding of the impact of this important procedure on liver transplantation, LDLT recipients and LDLT donors.