Cirrhosis

Below are current clinical trials.

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1. Transforming Non-Invasive Liver Disease Detection by MRE: The Hepatogram

   Rochester, Minn.

   A variety of liver insults lead to pathological changes in liver architecture that culminate in cirrhosis. While invasive liver biopsy was required to detect cirrhosis, the development of magnetic resonance elastography (MRE) has revolutionized our ability to detect liver fibrosis through non-invasive means that involve measurement of liver stiffness. However, a number of pathological findings occur in liver in response to various insults that precede cirrhosis and are clinically important to identify such as steatosis associated with NASH, inflammation associated with viral hepatitis, and congestion associated with cardiac hepatopathy. Detection of such entities provides essential diagnostic, prognostic, and treatment information but yet is not available non-invasively. Recent murine studies from this group of investigators has identified that MRE technology can be adapted to non-invasively detect these conditions. Implementing this into the practice will transform it by obviating the need for invasive liver biopsies in patients suspected of having such forms of suspected liver disease. This will differentiate Mayo from other institutions where such technology is not available.

   An additional aim of this study is to examine the impact of obstructive sleep apnea (OSA) on the pathogenesis of nonalcoholic fatty liver disease (NAFLD), both common comorbidities of obesity. Recent evidence indicates a potential link between OSA and severity of NASH and fibrosis, but the mechanisms of OSA- associated hypoxia on liver disease progression in NAFLD is unclear. This study offers the unique opportunity to analyze this association, as the study population will undergo routine evaluation for OSA, as part as the preoperative work-up prior to bariatric surgery.

2. A Study of Improving Liver Ultrasound Effectiveness for Fibrosis Staging

   Rochester, Minn.

   The purpose of this study is to assess the effectiveness of a new ultrasound technique for non-invasive evaluation of liver fibrosis.

3. A Study of the Development and Validation of an Ascites-Specific Patient Reported Outcomes Questionnaire

   Rochester, Minn.

   The purpose of this study is to develop and validate a brief patient reported outcomes questionaire that is responsive to ascites-related symptoms in liver cirrhosis.

4. Hepatocellular Carcinoma Early Detection Strategy Study

   Rochester, Minn.

   The purpose of this study is to evaluate the usefulness of new markers found in blood that might help to diagnose of liver cancer (HCC) early among people with cirrhosis. We hope that this study will show that these new markers could identify HCC at an earlier stage where better treatment options are available.

5. A Registry of Liver Tissue for Research

   Rochester, Minn.

   The purpose of the Hepatic Tissue Research Registry is to establish a local program to procure resected liver tissue and to gather critical patient and research information that will be utilized to develop a comprehensive biomedical database. This Registry data will be made accessible to scientists at Mayo, researchers outside of Mayo who have collaborations with Mayo researchers and to further biomedical and clinical research in liver biology, toxicology, cell transplantation, liver support therapy, and pathology.