Gastroenterology & GI Surgery

Liver Disease: Houston Methodist Leads a Revolution in National Care Standards

Nov. 17, 2023 - Eden McCleskey

With more than one-third of Texans considered obese, and diabetes cases expected to increase by 45% by 2030, Texas has some of the highest incidence and mortality rates for liver cancer and disease in the country.

Houston Methodist's Underwood Center for Digestive Diseases physicians collaborate with peers at the Sherrie and Alan Conover Center for Liver Disease & Transplantation and Houston Methodist J.C. Walter Jr. Transplant Center to provide a full spectrum of care for patients.

The Liver Disease Program at Houston Methodist Hospital

Houston Methodist has placed special emphasis on disease prevention in fatty liver disease, partnering with the bariatric and metabolic program. A dedicated metabolic liver disease program incorporates medical, nutritional and pharmacologic treatments for each patient.

Hepatologists remain committed to eradicating viral hepatitis with the very latest therapies and dedicated clinics.

Houston Methodist physicians have created a variety of programs that address conditions such as amyloidosis and alcohol-related liver disease.

The hospital has expanded its team to include surgeons with expertise in robotic surgery for hepatobiliary disease, which will also help expand options in the living donor liver transplant program.

Houston Methodist transplant hepatologists and surgeons have grown the liver transplant program to become one of the top two in the nation in terms of volume — 232 liver transplants were performed in 2022.

Liver transplant patient survival at Houston Methodist consistently exceeds expected outcomes, with the Scientific Registry of Transplant Recipients (SRTR) reporting a 92%-94% one-year survival rate for those transplanted here over the past decade.

Those impressive outcomes are attained even as Houston Methodist provides transplantation to patients with critical illness, including those on mechanical support and with exceptionally high "models for end-stage liver disease" (MELD) scores.

Transplant remains the best cure for liver cancer. However, the landscape is constantly changing, with more effective non-transplant therapies available today. Houston Methodist has invested in transplant oncology as an emerging specialty — one which combines the use and expansion of medical therapies with the expertise of the transplant center.

Houston Methodist partners with MD Anderson Cancer Center and the hospital's own Neal Cancer Center to transplant patients with large intrahepatic cholangiocarcinomas — such patients have an overall survival rate of greater than 80% at five years. This was facilitated by the adoption of novel approaches to assess tumor biology and behavior rather than tumor size alone for patients who do not meet traditional transplant criteria.

Clinical Differentiators

• We are among the nation's two largest and most comprehensive liver transplant programs.

• Liver perfusion helps us optimize potential donor organs, expanding the number of transplants we're able to perform.

• Our nationally recognized physician leaders push the envelope on standard treatments for liver and hepatobiliary cancers.

• Our surgical liver ICU is one of the highest acuity ICUs in the country.

• We employ robotic-assisted procedures for resection of hepatobiliary lesions and living donor transplant.

Research Initiatives

• Clinical trials of new treatments to prevent advanced disease

• Pharmaceutical and investigator-initiated trials that look at chemotherapy and immunosuppressant therapies before and after transplant to find optimal outcomes in high-risk patients

• Clinical trials examining nutrition and assessing calorie needs in patients with liver cancer

• Exploring the role of molecular profiling and its prognostic significance in predicting outcomes in various liver cancers in the non-transplant and post-transplant setting

• Trials looking at the combination of chemotherapy and immunotherapy, along with loco-regional therapies, in controlling large liver tumors in patients in the transplant and non-transplant setting

• Studies of noninvasive biomarkers and imaging modalities in assessing fibrosis in liver patients.

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