Adult to Adult LDLT Cohort Study

这项提案的目的是证明肝脏移植的医生和科学家小组 宾夕法尼亚大学的项目有兴趣、基础设施和资源参与 成人活体供肝移植(LDLT)队列研究。取得的进展 终末期肝病患者的护理一直受到可获得的有限的 供移植的捐献器官。成人至成人LDLT预计将显著扩大捐赠库，并 提供多个器官移植给指定的受者。初步结果令人鼓舞， 然而，有许多问题与捐赠者和接受者的结果有关，以及是否更好 对这些患者的管理可以改善这些结果。 一项成人环境下LDLT的前瞻性多中心研究有望：1.收集和分析数据 将协助建立选择捐赠者的可靠标准，审查符合以下条件的手术技术 与最好的短期和长期结果相关，并推荐长期随访的方法 捐赠者的身体和心理健康状况。2.确定受助者的结果与 身体定位和研究结果是否受手术前选择和准备的影响 技术，以及再生和免疫反应之间的相互关系。3.研究 移植中的临床实践和社会经济问题。 通过国家协作网络解决这些问题的成功将取决于科学 以及参与该联合体的中心的运营业绩。宾夕法尼亚大学移植中心 致力于参与这些合作努力，并为旨在 更好地了解LDLT的内科和外科问题。 我们的提案分为三个部分。第一节：介绍了联合国儿童基金会的资源和参与情况 宾夕法尼亚大学移植中心的医生团队。第二部分：网络环境的描述和策略 开发一个全面的数据库。第三部分：描述四年的两项研究建议 研究努力确定：a.再生过程、移植物功能、 同种免疫反应，以及B.LDLT对供者和受者的生物、心理和社会影响。

The aim of this proposal is to demonstrate that the group of physicians and scientists at the Liver Transplant Program of the University of Pennsylvania has the interest, infrastructure and resources to participate in the Living Donor Liver Transplantation (LDLT) Cohort Study among adults awaiting transplantation. Progress in the care of patients suffering from end stage liver disease has been hampered by the limited availability of donor organs for transplantation. Adult to adult LDLT is expected to significantly expand the donor pool and provide numerous organs to be transplanted into designated recipients. The initial results are encouraging, however, there are many questions related to donor and recipient outcomes and whether better management of these patients can improve these results. A prospective mutli-center study of LDLT in the adult setting is expected to: 1. Collect and analyze data that will assist in the establishment of reliable criteria for donor selection, examine operative techniques that are associated with the best short and long term outcomes, and recommend methods for long-term follow up of the donor's physical and psychosocial well being. 2. Determine recipient outcomes when compared to the cadaveric setting and study whether results are affected by preoperative selection and preparation, operative techniques, and the interrelationship between regeneration and immune response. 3. Study the effects of LDLT on clinical practice and socioeconomic issues in transplantation. Success in addressing these problems through a national collaborative network will depend on the scientific and operational performance of the centers involved in the consortium. The Penn Transplant center is committed to participate in these collaborative efforts, and contribute to the research efforts that are aimed at better understanding of medical and surgical issues of LDLT. Our proposal is divided into three sections. Section one: A description of the resources and participation of the team of physicians at Penn Transplant Center. Section two: A description and strategy for the development of a comprehensive database. Section three: Two research proposals describing a four year research effort to identify: a. the interrelationship between the regenerative process, graft function, alloimmune response, and b. the biopsychosocial impact of LDLT on donors and recipients.