School of Nursing
The only potentially life-saving option for end stage liver disease is liver transplantation (LT). In the United States, there were 8,250 LT procedures in 2018, costing ~$5 billion annually. Patient overall survival rates post-LT range from 70.9-93.8% (decreasing to 30% in some cases) depending on length of follow-up and pre-transplant liver status. Many patients die when they are on the waiting list.
A critical gap that needs to be addressed to improve LT survivability is to model the trajectory of liver disease complications over time during the pre-LT phase that are predicitive of better LT outcomes, and test the effect of interventions in changing these complications, providing new directions for LT evidence-based guidelines. The overall objective this project is to build a model, using the progression of liver disease complications and MELDNa change while on the waiting list, and to identify liver disease complications that can be changed with personalized interventions that have a beneficial effect in LT outcomes. In the long term, LT patients will be connected across the continuum of care, where interdisciplinary teams work closely with the patient to coordinate precise interventions to modify liver disease complications predictive of bad LT outcome.