Robert S. Brown Jr., MD, MPH
1) Determinants of the outcome of orthotopic liver transplantation (OLT) OLT is a highly successful therapy that has become a standard treatment for many forms of end stage liver disease. Since it is quite expensive, maximizing the benefit while decreasing the cost is of paramount importance. We are currently investigating the predictors of post-transplant outcomes in particular the impact of pre-transplant therapies like TIPS on cost and pre and post-transplant morbidity and mortality. 2) Quality of Life in Chronic Liver Disease Chronic liver disease greatly impairs patients ability to function both physically and within societal and family roles. The impact of liver disease on quality of life has not been extensively investigated. We are utilizing liver disease-specific quality of life instruments and to analyze the impact of liver disease and its treatment on patients with liver disease, those undergoing treatment for Hepatitis C and potential donor and recipients of living donor liver transplants. 3) Artificial Liver Support There is no currently viable support system for patients whose liver is failing analogous to dialysis for renal failure. Several devices have been proposed for this problem. These include those with living liver cells (bioartificial liver devices) and those without liver cells. We are actively involved in trials of both bioartificial as well as dialysis-based artificial liver support systems for acute and chronic liver failure. 4) Clinical Trials in Liver Disease and Transplantation I am involved in many active clinical trials in Liver disease. In addition to studies of artificial liver support, we have several active drug protocols for Hepatitis B and C. We are also currently participating in several multi-center studies to investigate anti-viral prophylaxis strategies as well as various immunosuppressive agents following liver transplantation.