Living Donor Liver Transplant - Predictive Models for Long-Term Health Outcomes

活体肝移植 - 长期健康结果的预测模型

基本信息

批准号：
8898952
负责人：
Michael M Abecassis
金额：
$ 0.23万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-17 至 2015-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8898952
关键词：
Achievement Address Adult Anatomy Caring Characteristics Clinical Communication Complex Comprehension Data Disclosure Effectiveness Funding Funding Opportunities Goals Health Health Status Healthcare Image Informed Consent Knowledge Life Liver Living Donor Liver Transplantation Living Donors Magnetic Resonance Imaging Measures Mediating Mediator of activation protein Modeling Morbidity - disease rate Organ Outcome Patient Outcomes Assessments Patients Peer Review Personal Satisfaction Postoperative Complications Procedures Process Psyche structure Publications Quality of life Recording of previous events Registries Reporting Research Research Personnel Resources Risk Risk Factors Safety Theoretical model Transplantation United States Universities cohort comparative demographics health literacy improved indexing instrument liver transplantation patient safety predictive modeling programs prospective psychosocial public health relevance social

项目摘要

DESCRIPTION (provided by applicant): The overarching goal of this proposal is to address the A2ALL Funding Opportunity Announcement objective to improve understanding of long-term health and well-being of living donors and on the efficacy of living donor liver transplantation (LDLT). Primary aims include: 1) characterizing risks, mediators, moderators, and outcomes that predict the long-term health and patient reported outcomes including well-being of potential living liver donors, and 2) characterizing risks, mediators, moderators, and outcomes that predict long-term outcomes of LDLT recipients and a composite donor-recipient predictive model for long-term outcomes of LDLT. A2ALL studies thus far have clearly demonstrated (LDLT) is a safe and effective alternative to deceased donor liver transplantation (DDLT). More specifically, data from A2ALL have quantified short-term donor morbidity and shown that LDLT recipient short-term morbidity, resource utilization, and other recipient clinical outcomes are comparable to those of DDLT. However, the long-term outcomes of living donation remain undefined, especially the impact of donation on the long-term health and well-being of living donors. Although risk factors that predict outcome are being developed for DDLT using data from national registries, such registries do not currently gather all of the measures needed to develop comprehensive risk predictor models specific to the outcomes of both the living donor and the LDLT recipient. While data on both donor and recipient characteristics have been collected from the current A2ALL cohorts, additional instruments need to be developed that include appropriate measures to fully characterize the risks related to long-term health status and patient reported outcomes including well-being. Finally, there is little knowledge and a lack of standards that focus on the complex healthcare processes involved in transplantation in general, and in LDLT in particular, that mediate and moderate the impact of risk factors on outcomes. Understanding LDLT processes and risk factors is particularly relevant since the enhancement of healthcare processes related to patient safety (e.g., clinician to clinician communication, coordination of care) and to clinician-patient communication (e.g., information exchange, informed consent) have improved health outcomes in other healthcare arenas. Therefore, there is a clear need to expand research on LDLT by exploring the impact of specific risk factors and the effect of healthcare process mediators on outcome domains of long-term health and well-being.

描述（由申请人提供）：该提案的总体目标是解决A2ALL资助机会公告目标，以提高人们对长期健康和对活捐助者的福祉以及对活捐助者肝脏肝脏移植（LDLT）有效性的理解。主要目的包括：1）表征风险，调解人，主持人和结果，这些风险预测长期健康和患者报告的结果，包括对潜在的活肝供体的幸福感，以及2）表征风险，调解人，主持人和既预测LDLT受体的长期胜任，并为LDLT的长期淘汰而产生长期供体供体的长期预测模型。到目前为止，A2ALL研究已清楚地证明（LDLT）是已故供体肝移植（DDLT）的安全有效替代方案。更具体地说，来自A2ALL的数据已经量化了短期供体的发病率，并表明LDLT受体短期发病率，资源利用和其他受体临床结果与DDLT的临床结果相当。但是，生活捐赠的长期成果仍然不确定，尤其是捐赠对长期健康和活捐助者福祉的影响。尽管使用来自国家注册表的数据为DDLT开发了预测结果的风险因素，但此类注册机构目前并未收集开发针对活捐赠者和LDLT接收者结果的全面风险预测模型所需的所有措施。尽管已经从当前的A2ALL队列中收集了有关捐助者和接受者特征的数据，但需要开发其他工具，其中包括适当的措施，以充分表征与长期健康状况和患者报告的结果有关的风险，包括幸福感。最后，几乎没有知识和缺乏标准，这些标准集中在一般而言，尤其是在LDLT中涉及的复杂医疗保健过程上，这些过程介导并调节了风险因素对结果的影响。了解LDLT过程和风险因素特别重要，因为与患者安全有关的医疗保健过程（例如临床医生的临床医生通信，护理协调）和临床医生患者沟通（例如，信息交流，知情同意）的增强已经改善了其他医疗保健领域的健康状况。因此，明确需要通过探索特定危险因素的影响以及医疗保健过程调解人对长期健康和福祉的结果领域的影响来扩大对LDLT的研究。