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UNC, NIH to Study Living-Donor Liver Transplants

Known as the Adult to Adult Living Donor Liver Transplant Cohort Study, the seven-year project will investigate the experience of patients eligible for living-donor liver transplants, concentrating on aspects that affect outcomes of recipients and donors.

"The main goal is to save lives on the recipient side and to do no harm on the donor side," said Roshan Shrestha, professor of medicine at the School of Medicine and principal investigator of the UNC study site.

NIH designated UNC as one of 10 medical centers in the nation to participate in the study.

"We feel fortunate to be selected," Shrestha said. "It's a great opportunity to answer questions about living-donor transplants in this country."

NIH looked at UNC's expertise, environment and credibility of program and personnel when it was selected as a participating site, Shrestha said.

"UNC was selected purely on merit," he said. "We are the front line in the study of living-donor liver transplants and have been involved since the earliest stages of this procedure."

Because of the shortage of donor livers for cadaveric transplants, many patients with liver disease have died while awaiting a donor.

Living-donor liver transplant, widely accepted for children in need of liver transplantation, has been used as an alternative for adults. But because it requires a larger portion of the liver, it is a more challenging procedure with potentially greater risks.

In January, Michael Hurewitz of Schuylerville, N.Y., died three days after a procedure in which he donated part of his liver to his brother, who had liver disease.

"Any time you do research on a healthy individual, there are risks involved," Shrestha said. "You have to make sure the individual understands those risks, and you need informed consent. This study will help better inform individuals in the future."

Several hundred adult-to-adult liver transplant procedures have been performed in the United States. According to the NIH Web site, living-donor liver transplant has the potential for changing the face of liver transplantation.

"At this point we don't have long-term data on recipient and donor," Shrestha said. "We need to systematically collect information among the centers to be able to answer the questions that surround (liver transplants)."

UNC began its living-donor liver transplant program in October 1996. Today, the UNC Center for Liver Diseases and Transplantation provides highly specialized care for patients with liver disease in North Carolina and surrounding areas.

"(Living-donor liver transplant) is one of the ways to expand the donor pool," Shrestha said. "If we had enough cadaveric donors, we wouldn't be doing this study. The crux of the matter is that there are way too many people waiting for liver transplants. That is why this study is important."

The University Editor can be reached at udesk@.unc.edu.

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