Patient Care

Managing the full spectrum of liver disease…

The Division of Hepatology at the University of Miami offers care for all types of liver disease seen in adults. We are a team of physicians, nurses, physician assistants and nurse practitioners dedicated to providing state of the art comprehensive care. We have a very busy outpatient ambulatory practice with daily clinics. In addition we have an inpatient service at the University of Miami Hospital where our patients who require hospitalization are admitted. Our Division is the medical arm of the liver transplant program within the Miami Transplant Institute.

We collaborate closely with our colleagues in other specialties including surgery, radiology, and pathology to provide state of the art diagnosis and management of liver disease in adults. Among the major causes of liver disease we also treat hepatitis B and C, fatty liver disease, autoimmune hepatitis and biliary cirrhosis. We evaluate patients with all types of liver disease referred for liver transplant as well as patients with primary liver cancers. In addition to having had advanced training in hepatology our faculty also trained in gastroenterology and thus are able to offer endoscopic evaluation for important complications of liver disease such as varices.

Among the important liver diseases we manage are:

Hepatitis C: This is the most frequent cause of liver disease in adults requiring liver transplant as it leads to cirrhosis and hepatocellular carcinoma. Although the number of newly infected individuals with hepatitis C has declined in recent years there are still many infected patients, many of whom are unaware of their infection, who require treatment. Fortunately treatment for hepatitis C has become increasingly effective and can now cure the majority of infected patients. Unfortunately a vaccine has not been developed to date to prevent hepatitis C.

*Hepatitis B: *Although less common in the United States than hepatitis C, hepatitis B worldwide is a major threat to health causing cirrhosis and hepatocellular carcinoma. Hepatitis B is commoner in Asia, Africa and parts of the Caribbean and is often diagnosed in immigrants from those areas. Vaccination programs started in the 1980’s have considerably reduced the spread of hepatitis B. Effective oral drugs have also had a major impact on the management of hepatitis B as it is now possible to suppress the activity of the hepatitis B virus helping to prevent liver failure and reduce the risk of hepatocellular carcinoma.

Alcoholic Liver Disease: Although a large number of individuals drink alcohol to excess fortunately it is only a minority who develop serious liver damage even after years of drinking heavily. Although substantial improvement in liver function can occur with long term abstinence from alcohol, patients are at risk of cirrhosis and hepatocellular carcinoma. Generally there is no specific drug therapy for alcoholic liver disease but in patients with recent alcohol use and active inflammation of the liver drugs to decrease inflammation may be beneficial.

*Fatty Liver: *This is rapidly becoming the most common type of liver disease in the United States. This in turn is related to the epidemic of obesity in the American population as a whole. Other important risk factors in addition to obesity include diabetes and elevated blood lipids. Fatty liver is also known as nonalcoholic fatty liver disease (“NAFLD”) as it has some features also seen in patients with a history of alcohol excess as the cause of their liver disease. To date no specific drug therapy has been developed to treat Fatty Liver. Weight loss and treatment of other factors such as diabetes are also advised.

Autoimmune Hepatitis: This type of liver disease although a “hepatitis” because it involves inflammation of the liver cells is not caused by a virus but rather by the body’s own immune system. It is most common in young to middle aged women, may be accompanied by abnormal antibodies produced by the body and usually responds very well to steroids.

Primary Biliary Cirrhosis: This type of liver disease is also more common in women. It causes sluggish bile flow in the liver. Often patients do not have cirrhosis in the early stages of the disease which often responds very well to treatment with ursodeoxycholic acid.

Primary Sclerosing Cholangitis: In contrast this liver disease is more common in males and is often seen in individuals who have colitis. It too is associated with sluggish bile flow through the liver, in this case often due to scarring of the bile ducts. There is no effective drug treatment yet but patients can benefit from stretching of the bile ducts endoscopically.

Hepatocellular Carcinoma: This an increasingly common tumor usually occurring in the presence of cirrhosis

To Schedule a clinic appointment call:
305-243-1204 Option 1