INTEGRATED CARE, DYNAMIC RESEARCH LIVER DISEASE: LEADING THE NATION AND CHALLENGING CURRENT CARE STANDARDS

With more than one-third of Texans considered obese in 2019, and diabetes cases expected to increase by 45% by 2030, Texas has some of the highest incidence and mortality rates for liver disease and liver cancer in the country.

Underwood Center 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.

We have placed special emphasis on disease prevention in fatty liver disease, partnering with our bariatric and metabolic program. We have a dedicated metabolic liver disease program that incorporates medical, nutritional and pharmacologic treatments for each patient. Our hepatologists remain committed to eradicating viral hepatitis with the very latest therapies and dedicated clinics. Our physicians have created a variety of programs that address conditions such as amyloidosis and alcohol-related liver disease. We expanded our team to include surgeons with expertise in robotic surgery for hepatobiliary disease, which will also help expand options in our living donor liver transplant program.

Houston Methodist transplant hepatologists and surgeons have evolved the liver transplant program to become one of the top two in the nation in terms of volume — performing 232 liver transplants 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% oneyear survival rate for those transplanted here over the past decade. Our excellent outcomes occur despite our intention to provide transplantation to patients with critical illness, including those with exceptionally high Model for End-Stage Liver Disease (MELD) scores and on mechanical support.

We know liver transplant remains the best cure for liver cancer; however, the landscape is changing with more effective nontransplant therapies. We have invested in transplant oncology as an emerging specialty — which combines the use and expansion of medical therapies with the expertise of our transplant center. We partner with MD Anderson Cancer Center and Houston Methodist Neal Cancer Center to transplant patients with large intrahepatic cholangiocarcinomas, yet maintain 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 nontransplant and posttransplant setting

• Trials looking at the combination of chemotherapy and immunotherapy, along with locoregional therapies, in controlling large liver tumors in patients in the transplant and nontransplant setting

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