Adult Living Donor Liver Transplantation Studies

The Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) was a consortium of 9 U.S. liver transplant centers performing adult-to-adult living donor liver transplant (AALDLT) with the primary goal of examining outcomes of AALDLT versus deceased donor liver transplant (DDLT). AALDLT is a relatively new procedure increasingly used at major transplantation centers. Relatively small numbers of cases are performed at any one center and approaches to the patient and donor are too diverse across centers to provide reliable and generalizable information on donor and recipient outcomes from individual centers. Therefore, the consortium was organized to accrue and follow sufficient numbers of patients being considered for and undergoing AALDLT to provide generalizable results from adequately powered studies.

The Adult to Adult Living Donor Liver Transplantation Cohort Study (A2ALL) consisted of both retrospective and prospective studies of AALDLT. Legacy data from the A2ALL retrospective cohort is housed in the NIDDK Data Repository. The A2ALL retrospective cohort comprised 819 adult patients, each with a potential living donor, evaluated between January 1, 1998 and February 28, 2003. The retrospective study was designed to gain initial insights into outcomes associated with liver transplant procedures, with data drawn from existing medical records and patient materials. It was hypothesized that pursuit of a living liver allograft leads to decreased pre-transplant morbidity and mortality and better long term outcomes for patients starting from the point at which listed patients have a potential donor evaluated (at least a history and physical examination). The study analyzed numerous variables to determine the factors influencing allograft survival in recipients.

The A2ALL study showed evidence that AALDLT is a viable option for liver replacement with outcomes that improve with center experience. Donor characteristics associated with survival included younger age and cold ischemia time of the right lobe graft.

Images from subjects enrolled in A2ALL are not included in the data package, but are now available upon request.

成人对成人活体供肝移植队列研究（Adult-to-Adult Living Donor Liver Transplantation Cohort Study, A2ALL）是由9家美国肝移植中心组成的学术联盟，其核心研究目标为对比成人对成人活体供肝移植（Adult-to-Adult Living Donor Liver Transplant, AALDLT）与尸体供肝移植（Deceased Donor Liver Transplant, DDLT）的预后结局。成人对成人活体供肝移植属于相对新兴的术式，目前在大型移植中心的应用愈发广泛。但单一中心的手术病例数相对有限，且不同中心针对受者与供者的诊疗方案差异较大，无法从单个中心获取供者与受者预后的可靠且可推广的研究结果。因此该联盟组建的初衷是积累并随访足够数量的拟接受或已接受成人对成人活体供肝移植的患者，以通过具备足够统计效力的研究获得可推广的研究结论。

成人对成人活体供肝移植队列研究（A2ALL）涵盖成人对成人活体供肝移植的回顾性与前瞻性两类研究。A2ALL回顾性队列的历史数据存放于美国国家糖尿病、消化和肾脏疾病研究所（National Institute of Diabetes and Digestive and Kidney Diseases, NIDDK）数据仓库中。该回顾性队列纳入了1998年1月1日至2003年2月28日期间完成潜在供者评估的819例成人患者，每位患者均配有潜在活体供者。本回顾性研究旨在初步明确肝移植术式相关的预后情况，研究数据来源于现有医疗记录与患者诊疗资料。研究提出假设：当等待移植的患者完成潜在供者评估（至少完成病史采集与体格检查）后，寻求活体肝移植可降低受者术前并发症发生率与死亡率，并改善患者长期预后。该研究分析了多项变量，以明确影响受者同种异体移植物存活的相关因素。

A2ALL研究结果证实，成人对成人活体供肝移植是一种可行的肝脏替代治疗方案，其预后结局可随中心手术经验的积累而得到改善。与供者术后存活相关的特征包括供者较年轻的年龄及右叶移植物的冷缺血时间。

A2ALL研究纳入受试者的影像资料未包含于本数据包中，但目前可通过正式申请获取该部分影像资料。