A United Approach Distinguishes Only Program in the Bronx from Others

A father must donate a portion of his liver to his infant son, who suffers from a rare disorder that prevents his liver from functioning properly and causes jaundice. A young woman eats contaminated shellfish while traveling abroad and contracts Hepatitis, which is destroying her liver and imperiling her health. A reformed alcoholic learns that years of drinking has impaired the function of his liver, requiring a liver transplant.

Dr. Allan Wolkoff with MSTP student Jo Choi
Patients living in and around the Bronx who need a liver transplant as a result of severe liver diseases such as these, now have access to that highly specialized surgery and critically important follow-up care in the borough of the Bronx. Area patients and their families can access this high-quality care locally, without having to travel long distances, as a result of the New York State Department of Health's approval, this summer, of the first and only liver transplant program in the Bronx, at Montefiore Medical Center, the University Hospital for Albert Einstein College of Medicine of Yeshiva University.

The liver transplant program is part of the Montefiore-Einstein Liver Center and includes a research component involving scientists from the College of Medicine's Marion Bessin Liver Research Center, a designated liver center funded by the National Institutes of Health.

"What sets our program apart from the many liver transplant programs nationwide is the interaction and cooperation between our two institutions," says Allen M. Spiegel, M.D., The Marilyn and Stanley M. Katz Dean of Albert Einstein College of Medicine. "Einstein scientists work closely with Montefiore physicians in furthering our understanding of liver function and failure, promoting prevention, and developing therapies. And, Einstein students and residents rotating through Montefiore benefit from broader opportunities for learning about liver disease."

"Our liver transplantation program fills a significant, unmet medical need for people who live in the Bronx and suffer from end-stage liver disease," adds Steven M. Safyer, M.D., president and CEO of Montefiore. "It now allows these patients to be cared for closer to home, by a team of professionals with an incredible amount of experience and expertise in all aspects of liver care."

The Bronx has one of the highest rates of liver disease in the country and the highest rate of liver disease in New York State. There are more than 2,300 people statewide currently waiting for a liver transplant, and statistics for New York State show that risk factors for liver disease are significantly higher for residents of the Bronx compared with other areas of the state.

Drs. Amy Lu, Sarah Bellemare, Paul Gaglio
& Milan Kinkhabwala
"We have a world class team of surgeons and liver specialists with a wide range of experience in treating and researching severe liver disease," says Milan Kinkhabwala, M.D., chief of transplantation and director of abdominal organ transplantation at Montefiore and a member of Einstein's Liver Research Center. "More than 120 Bronx patients were waiting for liver transplants in 2007, and approximately 50 local residents had no choice but to seek a liver transplant outside the borough last year."

The collaboration between Einstein and its University Hospital bridges research with clinical efforts. "Having the clinical program allows for true translational research, with the ability to bank excess human liver tissue that will be accessible to our researchers," notes Allan Wolkoff, M.D., chief of the Division of Hepatology at Einstein and Montefiore. Dr. Wolkoff is also associate director of Einstein's Marion Bessin Liver Research Center.

There are more than 30 principal investigators, including 5 M.D. hepatologists within the Liver Research Center, representing a dozen academic departments. "A number of our researchers are among the leaders in the study of liver cell transplantation," adds Dr. Wolkoff. "Using what they have learned in the lab, our hope is that eventually one liver may provide enough cells to treat multiple people."

Rounding, Hepatology Service,
Montefiore Medical Center
The collaboration also distinguishes Montefiore's unique capabilities as an academic medical center in helping to address severe liver disease through community-based outreach, patient and physician education and the patient care provided by a nationally recognized team of liver specialists. Thousands of patients suffering from serious liver diseases including Hepatitis C, cirrhosis and cancer are treated annually at Montefiore.

"In the Bronx, many individuals have diminished access to health care," says Paul Gaglio, MD, a nationally known liver expert and medical director of the Liver Transplant Program. "The number of hospitalizations for liver-related diagnoses in Bronx-area hospitals has increased substantially, magnifying the importance of having an easily accessible local liver transplant center in the Bronx."

"Through our outreach efforts we can begin to identify people who may have liver disease and be unaware of the risks to their health," says Dr. Wolkoff. "In addition, our work in the lab and in clinical settings can help dispel the stigma often attached to liver disease, which can be caused by numerous factors other than alcohol or drug abuse. The more we can educate everyone about liver health and prevention, the better the outcome will be for individuals faced with a life-threatening liver disease."