Functional Assessment in Liver Transplantation

NCT ID: NCT03228290

Last Updated: 2025-07-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

5000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-10-12

Study Completion Date

2028-12-31

Brief Summary

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This will be a prospective cohort study of patients with liver disease. Subjects will undergo geriatric assessments of frailty, functional status, and disability using functional status measures at baseline and at every clinic visit in the pre-transplant setting. Subjects will also answer questions regarding quality of life, personality, and/or cognitive function. Subjects will again undergo assessments at every clinic visit through 12 months after transplant. Then, they will be followed annually.

Detailed Description

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Patients will be asked to perform the following study procedures:

1. Assessment of cognitive function, quality of life, and/or personality using cognitive tests and questionnaires.
2. Measures of frailty and disability selected to capture the multi-dimensional aspects of frailty including functional status and physiologic reserve:

Fried Frailty Score: weakness (test of grip strength), exhaustion (patient interview), slowness (gait speed), low activity (patient interview) Short Physical Performance Battery: repeated chair stands, balance testing with feet together, 13-foot walk
3. Laboratory tests will all be obtained from the medical record: creatinine, total bilirubin, INR, sodium, albumin. All of these tests are necessary for listing for liver transplantation.
4. Blood draw, urine and stool samples will be collected for a sub-group of 1000 patients.
5. Adipose, muscle, liver tissue, and blood will be collected during the liver transplant surgery for a sub-group of 1000 patients.

Conditions

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End Stage Liver Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Adult (≥18 years old)
* Are seen for the treatment of liver disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jennifer C Lai, MD, MBA

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status COMPLETED

Loma Linda University

Loma Linda, California, United States

Site Status COMPLETED

University of California, San Francisco

San Francisco, California, United States

Site Status RECRUITING

Northwestern University

Chicago, Illinois, United States

Site Status RECRUITING

Indiana University

Indianapolis, Indiana, United States

Site Status ACTIVE_NOT_RECRUITING

Johns Hopkins

Baltimore, Maryland, United States

Site Status RECRUITING

University of Michigan

Ann Arbor, Michigan, United States

Site Status COMPLETED

Columbia University

New York, New York, United States

Site Status RECRUITING

Duke University Medical Center

Durham, North Carolina, United States

Site Status RECRUITING

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Baylor Scott & White Health

Dallas, Texas, United States

Site Status RECRUITING

University of Washington

Seattle, Washington, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jennifer C Lai, MD, MBA

Role: CONTACT

(415) 476-6422

Fawzy Barry, BS

Role: CONTACT

(415) 476-6119

Facility Contacts

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Jennifer C Lai, MD, MBA

Role: primary

415-476-2777

Fawzy Barry, BS

Role: backup

415-476-6119

Daniel Ganger, MD

Role: primary

312-695-4496

Cynthia Padilla, BS

Role: backup

312 926-4260

Betsy King, MD

Role: primary

630-244-6464

Jessica Ruck

Role: backup

203-536-0243

Elizabeth Verna, MD

Role: primary

212-305-9139

Geena George

Role: backup

212-305-3839

Matthew Kappus, MD

Role: primary

804-828-8786

Adele Gaskin

Role: backup

919-684-0742

Amit Tevar, MD

Role: primary

Rita Johnson, RN

Role: backup

412-383-8616

Robert Rahimi, MD

Role: primary

214-820-8500

Hannah Amundson

Role: backup

(214) 818-7940

Meredith Pearson, MD

Role: primary

Sabrina Omer

Role: backup

(206) 221-2004

References

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Lai JC, Feng S, Terrault NA, Lizaola B, Hayssen H, Covinsky K. Frailty predicts waitlist mortality in liver transplant candidates. Am J Transplant. 2014 Aug;14(8):1870-9. doi: 10.1111/ajt.12762. Epub 2014 Jun 16.

Reference Type RESULT
PMID: 24935609 (View on PubMed)

Lai JC, Covinsky KE, Hayssen H, Lizaola B, Dodge JL, Roberts JP, Terrault NA, Feng S. Clinician assessments of health status predict mortality in patients with end-stage liver disease awaiting liver transplantation. Liver Int. 2015 Sep;35(9):2167-73. doi: 10.1111/liv.12792. Epub 2015 Feb 12.

Reference Type RESULT
PMID: 25644788 (View on PubMed)

Wang CW, Covinsky KE, Feng S, Hayssen H, Segev DL, Lai JC. Functional impairment in older liver transplantation candidates: From the functional assessment in liver transplantation study. Liver Transpl. 2015 Dec;21(12):1465-70. doi: 10.1002/lt.24334. Epub 2015 Nov 6.

Reference Type RESULT
PMID: 26359787 (View on PubMed)

Lai JC, Dodge JL, Sen S, Covinsky K, Feng S. Functional decline in patients with cirrhosis awaiting liver transplantation: Results from the functional assessment in liver transplantation (FrAILT) study. Hepatology. 2016 Feb;63(2):574-80. doi: 10.1002/hep.28316. Epub 2015 Dec 16.

Reference Type RESULT
PMID: 26517301 (View on PubMed)

Wang CW, Feng S, Covinsky KE, Hayssen H, Zhou LQ, Yeh BM, Lai JC. A Comparison of Muscle Function, Mass, and Quality in Liver Transplant Candidates: Results From the Functional Assessment in Liver Transplantation Study. Transplantation. 2016 Aug;100(8):1692-8. doi: 10.1097/TP.0000000000001232.

Reference Type RESULT
PMID: 27314169 (View on PubMed)

Lai JC, Volk ML, Strasburg D, Alexander N. Performance-Based Measures Associate With Frailty in Patients With End-Stage Liver Disease. Transplantation. 2016 Dec;100(12):2656-2660. doi: 10.1097/TP.0000000000001433.

Reference Type RESULT
PMID: 27495749 (View on PubMed)

Sinclair M, Poltavskiy E, Dodge JL, Lai JC. Frailty is independently associated with increased hospitalisation days in patients on the liver transplant waitlist. World J Gastroenterol. 2017 Feb 7;23(5):899-905. doi: 10.3748/wjg.v23.i5.899.

Reference Type RESULT
PMID: 28223735 (View on PubMed)

Berry KA, Kent D, Seetharaman S, Wong R, Mohamad Y, Yao F, Nunez-Duarte M, Wadhwani SI, Boyarsky BJ, Rahimi RS, Duarte-Rojo A, Kappus MR, Volk ML, Ladner DP, Segev DL, McAdams-DeMarco M, Verna EC, Ganger DR, Lai JC. Loneliness in adults awaiting liver transplantation at 7 U.S. transplant centers. Ann Hepatol. 2022 Sep-Oct;27(5):100718. doi: 10.1016/j.aohep.2022.100718. Epub 2022 Apr 20.

Reference Type DERIVED
PMID: 35460882 (View on PubMed)

Berry K, Duarte-Rojo A, Grab JD, Dunn MA, Boyarsky BJ, Verna EC, Kappus MR, Volk ML, McAdams-DeMarco M, Segev DL, Ganger DR, Ladner DP, Shui A, Tincopa MA, Rahimi RS, Lai JC; from the Multi-Center Functional Assessment in Liver Transplantation (FrAILT) Study. Cognitive Impairment and Physical Frailty in Patients With Cirrhosis. Hepatol Commun. 2022 Jan;6(1):237-246. doi: 10.1002/hep4.1796. Epub 2021 Aug 24.

Reference Type DERIVED
PMID: 34558844 (View on PubMed)

Related Links

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http://liverfrailtyindex.ucsf.edu/

We developed a novel clinical liver frailty index, consisting of hand grip strength, timed chair stands, and balance testing, that correctly reclassifies 1 in 5 patients to their accurate survival status, compared to MELDNa alone.

Other Identifiers

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1R21AG067554

Identifier Type: NIH

Identifier Source: secondary_id

View Link

R21DK127275

Identifier Type: NIH

Identifier Source: secondary_id

View Link

11-07513

Identifier Type: -

Identifier Source: org_study_id

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