Liver Transplant Research Program

Physicians and scientists with the Liver Transplant Research Program in the Mayo Clinic Transplant Research Center conduct basic science research and clinical research directed at improving care before, during and after liver transplant for patients with liver failure and certain malignancies.

Research focus areas

The Liver Transplant Research Program has several research focus areas, including:

  • Acute liver failure and bioartificial liver support
  • Hepatic malignancies
  • Immunity and antibody-mediated rejection
  • Liver transplantation for rare diseases
  • Living-donor liver transplant
  • Obesity and cardiovascular disease management
  • Regeneration and stem cell therapy
  • Viral hepatitis

Here's a closer look at the research focus areas.

Acute liver failure and bioartificial liver support

Mayo Clinic researchers are investigating medical therapy, cellular therapy and liver assist device support for patients with acute and chronic liver failure.

Specific research activities include:

  • Clinical implementation of liver dialysis to treat encephalopathy and intractable pruritus, two devastating complications of chronic liver disease.
  • Development of a bioartificial liver support device that uses living cells to function in place of the diseased liver. The device is designed to keep patients with acute liver failure alive long enough to undergo emergency liver transplant or even to provide enough time for the diseased liver to regenerate and avoid transplantation altogether.

Hepatic malignancies

Physician-scientists in the Liver Transplant Research Program are conducting research to advance the protocol they developed for treatment of cholangiocarcinoma (bile duct cancer).

This protocol combines high-dose radiotherapy with chemotherapy followed by operative staging and liver transplant. The outstanding results achieved at Mayo Clinic have led to international acceptance of the efficacy of this protocol and changes to deceased-donor liver allocation.

Researchers in the liver transplant program are now seeking even better results, including use of adjuvant chemotherapy and changes in immunosuppression management designed to reduce the chance of tumor recurrence after transplant.

The Liver Transplant Research Program also includes basic science research and clinical research for other hepatic malignancies, including hepatocellular carcinoma, metastatic neuroendocrine cancer (islet and carcinoid tumors) and rare liver tumors, such as hepatic epithelioid hemangioendothelioma.

Specific areas of research for transplant in liver cancer include:

  • Adjuvant chemotherapy after transplant and immunosuppression management to reduce tumor recurrence
  • Imaging studies with new CT and MRI technology for earlier diagnosis and better management of liver malignancies
  • Diagnostic studies for cholangiocarcinoma, such as fluorescent in situ hybridization (FISH), that enable early detection and treatment of cancer with improved survival
  • Ablative techniques for hepatocellular carcinoma to reduce the risk of tumor progression for patients awaiting transplant and to reduce the risk of tumor recurrence after transplant

Immunity and antibody-mediated rejection

Liver transplant researchers also are working to understand the interaction between the transplanted liver and the recipient's immune responses, including the mechanisms underlying antibody-mediated rejection and immune tolerance. This line of research is coordinated across the solid organ transplant groups at Mayo Clinic — kidney, pancreas, heart and lung.

Current research projects include:

  • Studying multiorgan transplants to identify the mechanisms by which a transplanted liver protects other simultaneously transplanted organs from the same donor
  • Studying how antibodies damage donor livers and developing strategies for prevention and treatment
  • Studying treatment options to allow development of immune tolerance, including innovative cell-based therapies

Liver transplantation for rare diseases

In collaboration with colleagues throughout the world, Mayo Clinic researchers are helping lead multicenter registries and clinical trials designed to advance treatment for patients with rare liver diseases.

The Liver Transplant Research Program team has experience with transplantation for numerous rare and unusual diseases, including:

Patients with some of these rare diseases may require multiorgan transplantation. Mayo Clinic performs the highest number of combined heart and liver transplants in the United States.

In addition, a multidisciplinary team of Mayo Clinic physicians at all three campuses performs clinical research that targets liver disorders that lead to pulmonary problems.

This research focuses on such liver diseases as:

  • Alpha-1 antitrypsin deficiency
  • Hepatopulmonary syndrome
  • Hereditary hemorrhagic telangiectasia
  • Portopulmonary hypertension

Living-donor liver transplant

The crucial shortage of deceased-donor livers has resulted in an increased risk of death for patients awaiting transplant.

Living-donor liver transplant enables patients to undergo liver transplant much earlier in the course of their disease than is possible with deceased-donor liver transplant. Mayo Clinic has one of the largest living-donor liver transplant programs in the U.S.

Mayo Clinic researchers are working to overcome challenges faced with living-donor liver transplant. Researchers conduct and participate in studies designed to improve living-donor liver transplant outcomes, donor safety and donor recovery after liver donation.

Donor quality-of-life studies have led to wider acceptance of living-donor liver transplant and have helped improve the donation and transplant processes.

Obesity and cardiovascular disease management

Researchers are studying obesity, metabolic syndrome and cardiovascular disease on patients before, during and after liver transplant to help improve long-term survival.

Current projects include:

  • Evaluating the benefits of aggressive weight management protocols with advanced nutritional programs both before and after liver transplant
  • Evaluating the safety and effectiveness of bariatric procedures for patients with end-stage liver disease
  • Studying the efficacy of nonsurgical, endoscopic bariatric procedures in treating patients before and after transplantation
  • Studying cardiac risk assessment and management in patients with end-stage liver disease requiring liver transplantation, including strategies to reduce the risk of cardiac disease after transplantation

Regeneration and stem cell therapy

Researchers in the Liver Transplant Research Program are developing effective stem cell therapy and liver cell therapy for a variety of conditions.

Current studies are investigating:

  • The role and benefit of stem cells to treat organ failure, to potentially prolong patient survival while awaiting emergency transplantation, or to avert the need for transplant altogether
  • Experimental models to treat inherited metabolic disorders with liver cell therapy
  • Growth of human liver cells in animal models as a source for cell therapy and bioartificial liver support devices
  • Cellular regeneration for the treatment of hepatic malignancies

Viral hepatitis

Hepatitis C has become a very treatable disease. However, some patients develop cirrhosis from hepatitis C and need liver transplantation.

Hepatologists in the Liver Transplant Research Program are involved in clinical trials for the treatment of hepatitis C before and after liver transplantation. They also are investigating the long-term effects and benefits of eradicating the virus in liver transplant recipients.