Health Conditions
Advanced Liver Disease
Advanced Liver Disease, is also known as End Stage Liver Disease, Chronic Liver Failure, or Decompensated Cirrhosis. In Advanced Liver Disease the liver becomes severely scarred (cirrhosis), which prevents it from functioning properly. It can eventually lead to liver failure.
Symptoms
Patients with Advanced Liver Disease can experience:
Abdominal pain
Nausea
Vomiting
Fatigue
Yellow skin and nails (jaundice)
Swollen legs
Shortness of breath
Causes
There are numerous causes of Advanced Liver Disease, the most common include: fatty liver, overconsumption of alcohol, poor diet and/or obesity, reactions to medications, and viral hepatitis.
Treatment
There is no cure for Advanced Liver Disease, the scarring (cirrhosis) is not reversible. However, it is important to slow and manage the progression of the disease. A high protein, low salt diet and diuretics (pill to help remove water from the body) help with ascites (fluid buildup). Procedures to manage Advanced Liver Disease include regularly removing excess fluid from the belly, placement of a stent to improve liver function or, as a last resort, liver transplant. Medication treatments for Advanced Liver Disease focus on preventing infection, reducing toxin buildup and removing excess fluid from the body.
Microbiota Therapy Research
ACT research partners at the University of Minnesota and Virginia Commonwealth University have completed placebo-controlled trials investigating the impact of microbial restoration in patients with End Stage Liver Disease, Cirrhosis, and Hepatic Encephalopathy.
Clinical Trial: Intestinal Microbiota Transplant in Alcohol-Associated Liver Disease (IMPACT)
Trial Locations:
Richmond VA Medical Center – Richmond, VA
Virginia Commonwealth University – Richmond, VA
Trial Status: Underway
Trial Summary:
Researchers at the Richmond Veterans Affairs Medical Center and Virginia Commonwealth University are completing a phase 2 clinical trial to test the safety, tolerability, and effectiveness of microbiota transplant therapy capsules when used to treat alcohol craving and drinking.
For more information visit: https://clinicaltrials.gov/study/NCT05548452Clinical Trial: Microbiota trAnSplant ThERaPy In hEpatiC Encephalopathy (MASTERPIECE)
Trial Locations:
Richmond VA Medical Center – Richmond, VA
Dallas VA Medical Center – Dallas, TX
Clinical Epidemiology Research Center – West Haven, CT
Trial Status: Emerging
Trial Summary:
A phase II randomized placebo-controlled, double-blind trial is emerging at three locations to investigate if microbiota transplant therapy can prevent future episodes of hepatic encephalopathy in patients with Advanced Liver Disease and cirrhosis.
For more information, visit: https://clinicaltrials.gov/study/NCT07528690Clinical Trial: FMT in Cirrhosis and Hepatic Encephalopathy (THEMATIC)
Trial Locations:
Richmond VA Medical Center – Richmond, VA
Virginia Commonwealth University – Richmond, VA
Trial Status: Completed
Trial Summary:
Dr. Jasmohan Bajaj and his research team at the Richmond Veterans Affairs Medical Center and Virginia Commonwealth University found patients who received Fecal Microbiota Transplant had lower recurrences of Hepatic Encephalopathy than patients who received placebo. All patients also received current standard of care treatments Lactulose, to reduce ammonia in the bloodstream, and Rifaximin, an intestinal, non-absorbent, antibacterial agent.
For more information, visit: https://clinicaltrials.gov/study/NCT03796598
To read the study publication, visit: https://pubmed.ncbi.nlm.nih.gov/39800192/Clinical Trial: Fecal Transplant in Recurrent Encephalopathy
Trial Locations:
Richmond VA Medical Center – Richmond, VA
Virginia Commonwealth University – Richmond, VA
Trial Status: Completed
Trial Summary:
A phase I randomized, open label trial was completed at the Richmond VA Medical Center to investigate the efficacy of fecal microbiota transplant on patients with recurrent hepatic encephalopathy. The study found that patients with hepatic encephalopathy who received microbiota transplants from donors with higher levels of two microbial strains matching deficiencies in HE patients had improved microbial diversity, cognition and fewer hospitalizations.
For more information, visit: https://clinicaltrials.gov/study/NCT02636647
To read the study publication, visit: https://pmc.ncbi.nlm.nih.gov/articles/PMC6102730/
Research Partner Perspectives
2022 Research Update: Dr. Bajaj
Research Alerts