PROJECT SUMMARY/ABSTRACT Transplantation holds the promise of reversing the clinical course for millions of Americans afflicted with end- stage liver disease. However, several issues limit broader access to liver transplantation and better outcomes including an incomplete understanding of liver disease pathogenesis, the need for better therapies and assessment of clinical outcomes, improved donor availability and access to medical care. Therefore, the long- term objective of the Transplant Surgery Scientist Training Program (TSSTP) is to foster and support multi- disciplinary, inter-departmental liver transplant-related research that will improve outcomes for patients with end- stage liver diseases. We will leverage scientific advances in the life sciences across many academic disciplines, with a goal of improving the health of pre- and post-transplantation liver patients, consistent with the mission of NIDDK. The TSSTP will train the next generation of surgeons, hepatologists and PhD investigators in a broad range of liver transplantation-related fields. The goals of the program are to educate trainees about the nature of existing barriers that hinder improved access, lower complications, and improve outcomes in liver transplantation; and to train TSSTP trainees with a deep knowledge of state-of-the art tools, methodologies, and scientific approaches that may be used to overcome these barriers. We will apply a team science approach that utilizes the Modular Approach to Transplant Research by Inter-disciplinary eXperts (MATRIX) model which promotes the concept of inter-dependent, multi-disciplinary research. The MATRIX training model builds on the interdisciplinary team science structure within the Comprehensive Transplant Center (CTC) and offers 1) a basic and translational scientific research track within the Northwestern University Collaborative for Transplant Research in Immuno/Hepatobiology and Biomedical Engineering (NUCTRIBE), and 2) outcomes science track within the Northwestern University Transplant Outcomes Research Collaborative (NUTORC). Trainees will benefit from a customized MATRIX that will incorporate multi-disciplinary mentoring from both NUCTRIBE and NUTORC (3-5 TSSTP mentors). Each project must have a link to liver transplantation or hepatology, and enhancing our long-term goal of improving patient care. In order to successfully reach these goals, we seek to: 1) provide inter-disciplinary training and mentorship that brings together clinicians and scientists with state-of- the-art research methodologists; 2) sustain an administrative structure that enhances quality and diversity of the candidate pool and trainees; 3) conduct rigorous and responsible research; 4) optimize mentor and trainee feedback with an ongoing evaluation process to enhance the ability of the program to meet its goals and objectives; and 5) provide training opportunities, including many lectures and seminars, that span NUCTRIBE and NUTORC at their intersection with clinical liver transplantation. This comprehensive, multi-disciplinary approach will allow us to enhance our liver transplantation-related research and train the next generation on physicians and scientists so that we can improve patient care.

PROJECT NARRATIVE Liver transplantation improves the quality of life and may be lifesaving for patients with end-stage liver disease, but improved outcomes for pre- and post-transplant patients requires better therapies and assessments of clinical outcomes, improved donor availability and increased access to medical care. The long-term objective of the Transplant Surgery Scientist Training Program, consistent with that of the Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grant (Parent T32), is to train the next generation of physicians – especially surgeons - and scientists who can leverage scientific advances across many academic disciplines to advance the field of transplantation through team science. By fostering and supporting the training of inter-disciplinary liver transplant-related research, we can improve the health of patients with liver diseases, consistent with the mission of NIDDK.