We propose to expand and maintain the Adult to Adult Living Donor Liver Transplantation Cohort Study Data Coordinating Center (A2ALL DCC) that will support a consortium of transplant centers in conducting continued observational and interventional research in living donor liver transplantation (LDLT) so as to facilitate understanding of the short and long-term medical and health-related quality of life outcomes of transplantation on living individuals who have donated a liver lobe as well as those who are candidates for and/or recipients of LDLT procedures. In addition, we will gain insight into liver regeneration and other biological processes through study of this unique procedure. The proposed DCC consists of the original A2ALL DCC team of collaborating experts in the fields of live organ donor transplantation, hepatology, clinical research design, database management, and research involving linkages of large public and private electronic health care databases. The DCC will continue to support the project, including research coordination, communications and logistics, study design, centralized data management, and analytical expertise. The specific scientific aims of the DCC will be developed in collaboration with the A2ALL Steering Committee. Proposed scientific activities include: 1) determination of long-term LDLT donor outcomes, including health-related quality of life, 2) protocols for immunosuppression minimization in the LDLT setting, 3) continued focus on hepatitis C and hepatocellular carcinoma, 4) identification of recipient and donor characteristics that are most favorable for LDLT, and 5) evaluation of newer approaches to LDLT to improve donor and recipient outcomes.
Society and the professional transplant community are obligated to past and future live organ donors and their recipients to learn from their experiences. Building on the success of the A2ALL consortium in achieving many of its original goals, several important research issues and clinical questions regarding LDLT still need to be addressed. Foremost among these issues is determining the long-term health and well-being of living liver donors. Understanding of the safety of LDLT must extend beyond short-term issues of post-operative complications of donors and recipients, resource utilization, recovery time, and restoration of adequate liver function. Critical to assessment of the long-term health of donors is comparison to persons with similar characteristics who did not donate. Important questions also remain regarding the use of LDLT in potential recipients: the possibility of immunosuppression minimization, use of LDLT grafts in special populations (e.g. persons with hepatocellular carcinoma and/or hepatitis C virus infection), and studying characteristics to identify those recipients who might do better with an LDLT graft than a DDLT graft. This study proposes to continue to use the structure built in the original project to answer these, key research questions.
|Mandell, M Susan; Smith, Abigail R; Dew, Mary Amanda et al. (2016) Early Postoperative Pain and its Predictors in the Adult to Adult Living Donor Liver Transplantation Cohort Study. Transplantation 100:2362-2371|
|Gordon, Fredric D; Goldberg, David S; Goodrich, Nathan P et al. (2016) Recurrent primary sclerosing cholangitis in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study: Comparison of risk factors between living and deceased donor recipients. Liver Transpl 22:1214-22|
|Samstein, B; Smith, A R; Freise, C E et al. (2016) Complications and Their Resolution in Recipients of Deceased and Living Donor Liver Transplants: Findings From the A2ALL Cohort Study. Am J Transplant 16:594-602|
|Levitsky, Josh; Goldberg, David; Smith, Abigail R et al. (2016) Acute Rejection Increases Risk of Graft Failure and Death inÂ Recent Liver Transplant Recipients. Clin Gastroenterol Hepatol :|
|Dew, Mary Amanda; DiMartini, Andrea F; Ladner, Daniela P et al. (2016) Psychosocial Outcomes 3 to 10 Years After Donation in the Adult to Adult Living Donor Liver Transplantation Cohort Study. Transplantation 100:1257-69|
|Pomposelli, James J; Goodrich, Nathan P; Emond, Jean C et al. (2016) Patterns of Early Allograft Dysfunction in Adult Live Donor Liver Transplantation: The A2ALL Experience. Transplantation 100:1490-9|
|Olthoff, Kim M; Smith, Abigail R; Abecassis, Michael et al. (2015) Defining long-term outcomes with living donor liver transplantation in North America. Ann Surg 262:465-75; discussion 473-5|
|DiMartini, Andrea F; Dew, Mary Amanda; Butt, Zeeshan et al. (2015) Patterns and predictors of sexual function after liver donation: The Adult-to-Adult Living Donor Liver Transplantation Cohort study. Liver Transpl 21:670-82|
|Olthoff, Kim M; Emond, Jean C; Shearon, Tempie H et al. (2015) Liver regeneration after living donor transplantation: adult-to-adult living donor liver transplantation cohort study. Liver Transpl 21:79-88|
|Smith, Abigail R; Schaubel, Douglas E (2015) Time-dependent prognostic score matching for recurrent event analysis to evaluate a treatment assigned during follow-up. Biometrics 71:950-9|
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