Core Component D: Gastrdenterology, Pulmonary, and Nephrology Services The overall objective of Core D is to enhance the quality of the clinical research studies conducted throughout the program project; it is critical to and highly integrated with the .specific aims of Projects 1, 2, 3, 5, and 6. Specifically, the Core staff are involved in initial protocol review and participate in the definition of gastrointestinal, hepatic, pulmonary, and renal study endpoints, ensuring standardized patient evaluations, specimen collection, and interpretation. Both the Gastroenterology/Hepatology and Pulmonary programs have had a presence at the FHCRC for 30 years; their faculty, research nurses, and technicians have as their sole activity the care of transplant patients and support of FHCRC research activities. The addition of Nephology services broadens the Core services provided to Project investigators. Both acute and chronic kidney disease affect the outcome of patients enrolled in protocols described in this grant. The personnel of this Core have extensive experience in evaluating organ dysfunction in patients undergoing hematopoietic cell transplant. Through the organization of the Core, highly accurate data are supplied to investigators at a cost saving because of economies of scale. Facilities include in-patient and out-patient endoscopy suites, dedicated subspecialty clinic areas for transplant patients, a Pulmonary Function Laboratory specifically for transplant patients, and centralized computer systems for access to and storage of clinical and research data. The Core staff have an ongoing and very effective interaction with Biostatistics (Core A), Pathology (Core B), Microbiology and Virology (Core C), and Long-term Follow-up (Core F) faculty, staff, and laboratories. Working closely with transplant physicians and investigators, the Core members have developed large cross-relational databases generated from both research and clinical assessments. This database has become an extremely valuable resource for retrospective analysis and hypothesis testing and is highly integrated with Biostatistics so that data are available to all FHCRC investigators. This Core provides state-of-the art care for patients being treated for their underlying leukemia. Relevance to public health: The projects described in this grant are intended to cure cancer, specifically cancers, involving the blood, commonly known as leukemias. The methods that will be used to cure leukemia may have side effects that involve the gastrointestinal tract, liver, lungs, and kidneys. This Core component has as its goal the prevention and treatment of these side-effects.