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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK062536-04
Application #
6945876
Study Section
Special Emphasis Panel (ZDK1-GRB-D (M1))
Program Officer
Everhart, James
Project Start
2002-09-17
Project End
2009-08-31
Budget Start
2005-09-01
Budget End
2006-08-31
Support Year
4
Fiscal Year
2005
Total Cost
$368,187
Indirect Cost
Name
University of Colorado Denver
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Dew, Mary Amanda; Butt, Zeeshan; Liu, Qian et al. (2018) Prevalence and Predictors of Patient-Reported Long-term Mental and Physical Health After Donation in the Adult-to-Adult Living-Donor Liver Transplantation Cohort Study. Transplantation 102:105-118
Butt, Zeeshan; DiMartini, Andrea F; Liu, Qian et al. (2018) Fatigue, Pain, and Other Physical Symptoms of Living Liver Donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study. Liver Transpl 24:1221-1232
Butt, Z; Dew, M A; Liu, Q et al. (2017) Psychological Outcomes of Living Liver Donors From a Multicenter Prospective Study: Results From the Adult-to-Adult Living Donor Liver Transplantation Cohort Study2 (A2ALL-2). Am J Transplant 17:1267-1277
Levitsky, Josh; Goldberg, David; Smith, Abigail R et al. (2017) Acute Rejection Increases Risk of Graft Failure and Death in Recent Liver Transplant Recipients. Clin Gastroenterol Hepatol 15:584-593.e2
DiMartini, A; Dew, M A; Liu, Q et al. (2017) Social and Financial Outcomes of Living Liver Donation: A Prospective Investigation Within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2). Am J Transplant 17:1081-1096
Baker, Talia B; Zimmerman, Michael A; Goodrich, Nathan P et al. (2017) Biliary reconstructive techniques and associated anatomic variants in adult living donor liver transplantations: The adult-to-adult living donor liver transplantation cohort study experience. Liver Transpl 23:1519-1530
Emond, Jean C; Goodrich, Nathan P; Pomposelli, James J et al. (2017) Hepatic Hemodynamics and Portal Flow Modulation: The A2ALL Experience. Transplantation 101:2375-2384
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
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
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

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