The University Health Network has the busiest right lobe live liver donor program in North America with a stable rate of approximately 50 cases per year. We have performed a total of 282 right lobe liver donor operations with no permanent donor morbidity and no donor deaths. Our 5-year graft survival rates are >80% comparable to the results of deceased donor transplantation at our center We have been acadmically productive with 17 manuscripts on our live donor experience published or in press. Membership in the A2ALL consortium will build on our strong record of successful collaborative liver transplant studies.
AIM 1 : To contribute to the A2ALL prospective longitudinal studies of donor and recipient outcomes through participation in co-investigator studies;and the collection, contribution, and analysis of our data and biospecimens.
AIM 2 : To conduct and complete two site-initiated investigator studies: a) A comprehensive, longitudinal, cohort study of donor morbidity, mortality and health related quality of life (HRQOL) using donors that have been excluded on anatomic grounds as controls. b) A study to determine if plasma and liver tisssue expression of the novel CD4(+)CD25(+) regulatory T cell effector molecule - fibrinogen-like protein 2 (FGL2) - can be used as a biomarker for i) the rapidity and severity of hepatitis C recurrence after live donor liver transplantation;and ii) the response to treatment of recurrence after live donor liver transplantation. Live donor liver transplants provide an ideal model to test this hypothesis because there is limited outcome variation due to the variability in the health of the donor liver and organ preservation times are relatively constant.

Public Health Relevance

It is critical to have accurate data on HRQOL after live liver donation to allow potential donors to fully make informed decisions about this high risk procedure. HCV is the major problem limiting the long term results of LD-OLT. Confirmation of the utility of FGL2 as a biomaker will help to tailor treatment and provide a new therapeutic target for more effective therapies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01DK085563-05S1
Application #
8917356
Study Section
Special Emphasis Panel (ZDK1-GRB-8 (O2))
Program Officer
Sherker, Averell H
Project Start
2009-09-30
Project End
2015-08-31
Budget Start
2014-09-01
Budget End
2015-08-31
Support Year
5
Fiscal Year
2014
Total Cost
$9,963
Indirect Cost
$738
Name
University Health Network
Department
Type
DUNS #
208469486
City
Toronto
State
ON
Country
Canada
Zip Code
M5 2-M9
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
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
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
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

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