Personalized Exercise Program Improves Survival Rate in Liver Transplant Patients

Principal Investigator: Daniela P. Ladner, MD, MPH, Interim Director, Comprehensive Transplant Center; Professor of Surgery (Organ Transplantation) and Medical Social Sciences, Northwestern University Feinberg School of Medicine Patients with poor physical conditioning who are diagnosed with cirrhosis frequently experience worse outcomes before and after receiving a liver transplant. Exercise helps reduce frailty and leads to better outcomes, but patients face a variety of financial and logistical barriers to the regular physical activity needed to maintain strength. Additionally, transplant teams often expect patients to optimize their physical health on their own with little guidance. The Ladner research team seeks to optimize patient outcomes through a practical and affordable approach to enhance physical conditioning in the pre- and post-liver transplant setting. The researchers are developing a simple and cost-effective intervention called LIFT (Liver FrailTY), which will include a full in-person strength assessment, an exercise program with smart phone guidance, and remote coaching. Regular and frequent check-ins will be essential to encouraging patients to achieve recommended levels of exercise. Dr. Ladner’s study will then measure the impact of LIFT on strength as well as on positive clinical outcomes, such as increased survival and fewer hospitalizations for patients facing liver...

Predicting Relapse in Liver Failure (Autoimmune Hepatitis) Patients for Personalized Treatment

Principal Investigator: Josh Levitsky, MD, Professor of Medicine (Gastroenterology and Hepatology), Medical Education and Surgery (Organ Transplantation), Northwestern University Feinberg School of Medicine Autoimmune hepatitis (AIH) occurs when the body’s immune system attacks its own liver cells, causing long term scarring and damage to the liver. No one knows precisely what causes autoimmune hepatitis (AIH), but it is diagnosed more frequently in patients with other autoimmune diseases (e.g., celiac disease, ulcerative colitis, rheumatoid arthritis, etc.) and in women, and often begins in adolescence or young adulthood.  Standard treatment focuses on suppressing the immune system with medications, yet immunosuppressants have many potentially harmful side effects. General recommendations call for patients to stop taking the medications when they are no longer needed. Unfortunately, without them, most patients soon relapse and risk more liver injury. Currently, tracking relapses requires taking a biopsy of the liver—a very invasive procedure—and looking at it under the microscope. The Levisky lab believes that measuring levels of biomarkers in the blood may offer a less invasive window into the liver than a traditional biopsy, giving physicians the ability to predict AIH relapse before the liver incurs any damage. This project offers the potential for better monitoring of patients with AIH. It also may shape the future of personalized treatments to individualize immunosuppressant therapy by using simple, cost effective blood draws rather than riskier liver...

Decreasing Risk of Life Saving TIPS Procedure in Liver Failure Patients

Principal Investigator: Lisa B. VanWagner MD, MS, Assistant Professor of Medicine (Gastroenterology and Hepatology) and Preventive Medicine (Epidemiology) Cirrhosis of the liver affects millions of Americans and leads to increased and life-threatening pressure in the blood vessels of the liver. One of the core treatments for this potentially deadly complication is a procedure called “TIPS.” While effectively reducing pressure in the liver, TIPS can result in heart failure in at least 20% of patients. The ability to identify patients at risk for cardiac dysfunction would allow clinicians to put into place targeted prevention strategies before and after TIPS. With that aim in mind, the VanWagner team is evaluating new imaging methods of the heart and liver to better understand how TIPS alters liver hemodynamics and changes cardiovascular structure, function, and flow in patients with cirrhosis undergoing TIPS. Study findings could lead to interventions to prevent the development of heart failure in this at-risk patient population, so more patients facing liver cirrhosis could safely receive the TIPS treatment while reducing the associated risk of heart...

Diagnosing Life Threatening Liver Disease (GALD) in Newborns Improves Chance of Survival

Principal Investigator: Sarah Taylor, MD, Assistant Professor of Pediatrics (Gastroenterology, Hepatology, and Nutrition), Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern Medicine, Feinberg School of Medicine  Gestational alloimmune liver disease (GALD) is the leading cause of liver failure in newborns. This disease occurs when maternal antibodies injure the liver of the fetus during pregnancy. Infants with GALD require prompt diagnosis and treatment at birth. Even with treatment, about 50% of infants with GALD do not survive. Quickly obtaining a precise and reliable diagnosis remains challenging. DHF’s grant is enabling Dr. Taylor’s lab to create histologic scoring criteria that can be easily disseminated to enable prompt and reliable diagnosis of GALD. Evaluating the ribonucleic acid (RNA) of livers from affected patients, the Taylor team hopes to identify new blood tests that will differentiate GALD from other causes of neonatal liver failure. Dr. Taylor’s research is fostering a better understanding of GALD’s disease process to help launch future research and the development of life-saving therapies for newborns facing this potentially deadly...

Division of Gastroenterology and Hepatology Northwestern Medicine/Feinberg School of Medicine
Center for Artificial Intelligence and Mathematics in Gastroenterology

Division of Gastroenterology and Hepatology Northwestern Medicine/Feinberg School of Medicine Center for Artificial Intelligence and Mathematics in Gastroenterology The Center for Artificial Intelligence and Mathematics in Gastroenterology (AIM-GI) is a first of its kind program developed in a division of Gastroenterology.  Artificial Intelligence and Machine Learning have the potential to vastly improve our ability to accurately predict, diagnose and treat our patients living with digestive diseases.  Through collaboration with engineers at the McCormick School of Engineering and physician scientists at the Feinberg School of Medicine at Northwestern University, our team has been incorporating mathematical modeling and advanced programming to study the mechanisms that lead to poor gastrointestinal function.  This work led to the development of a more formalized center that focuses on three main initiatives. Development of virtual organs which can be used to study the effects of surgery and medications; Development of new hybrid diagnostic tools using AI and machine learning to enhance diagnosis; Using machine learning and neutral networks to predict disease outcome. Although this is a new program, we have already had success developing an NIH funded Center of Research Expertise (CORE) and we have also developed new AI prototypes that can improve diagnostic accuracy and reliability of motility tests.  This work is supported by the generosity of the Digestive Health Foundation and these funds help provide the computational power and expertise required to continue to develop these innovative tools.  Our goal is to continue invent and develop new approaches and our partnership with the Digestive Disease Foundation will continue to allow us to grow and evolve this...