Adult to adult living donor liver transplantation cohor*

活体肝移植作为一种治疗选择已迅速获得接受， 终末期肝病患者。在过去的5年里，LDLT已经从大约50 - 60 从每年的300例增加到今年的近500例，占所有肝移植手术的近10%。 美国的虽然小系列患者的报告已经证明，LDLT可以在技术上 进行了相对较少的问题，没有对照研究评估这一疗效 与尸体移植相比。对LDLT的仔细评估是必要的，因为 这一过程对肝移植的潜在影响。LDLT队列研究是一项多中心研究， 对照研究，旨在测量LDLT的供体和受体的结果。有几 LDLT队列研究将解决的重要问题。首先，直接比较 与尸体移植相比，将进行LDLT的接受者。自选择LDLT以来 由于受体不同于尸体移植，因此必须谨慎选择本研究的对照组。 其次，LDLT可能通过减少移植前的等待时间来降低等待名单的死亡率。 此外，有初步数据表明，LDLT接受者与丙型肝炎（这是最 LDLT的常见适应症）与其尸体对应物相比可能具有更差的结果。的 必须评估LDLT对供体的影响。根据定义，活体捐赠者是健康的个体， 在没有个人利益的情况下接受腹部大手术目前，关于这方面的数据很少。 供体手术对供体存活率和生活质量的影响。因此，当务之急是 确定与LDLT相关的供体死亡率和发病率。最后，LDLT队列研究 提供了一个机会，以直接的总成本的LDLT与尸体移植。建成后 通过LDLT队列研究，医学界将对这一影响有更清楚的了解。 肝移植重要步骤、LDLT受者和LDLT供体。

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.