Liver disease is among the ten most important causes of death in the United States. However, over the last 10-15 years, there has been a remarkable expansion of basic knowledge in liver biology. This knowledge has led to new modalities for managing the various forms of acute and chronic liver disease. Treatments of viral hepatitis and liver transplantation have captured the headlines, but considerable progress has occurred also in therapy of portal hypertension, gene transfer, and cell transplantation for genetic liver disease, bioartificial liver support for acute liver failure, pathogenesis and therapy of cholestatic diseases, antifibrotic therapy and many others. The extraordinary progress has created a demand for well-trained hepatologists, in particular those who both contribute to current advances in basic knowledge and take disease management to the next level. While progress has been impressive, hepatitis C, hepatocellular carcinoma, and obesity-related liver disease (nonalcoholic steatohepatitis, or NASH) are looming epidemics, for which liver transplantation will not be a realistic solution for all, given the limitation of organ supply. Therefore, we see the training of research hepatologists as a national priority. The Division of Gastroenterology at UCSF has a 30 year history of preeminence in the research and treatment of liver diseases, with an NIH-funded Liver Center since 1975 and, since 1988, a Liver Transplant Program in partnership with the Department of Surgery. Through the Liver Center and joint mentorship of trainees, the Division is closely allied also with the basic sciences at UCSF and the Immunology Program in particular. This application is for funds for a two-year training experience in clinical or basic research, for two individuals annually, in Advanced Hepatology. The program faculty represents the Departments of Immunology/ Microbiology and Pathology as well as Medicine and Surgery. Fellows who select clinical research will receive formal training in clinical/outcomes methodology, with an option to earn an MS or MPH degree. Those in basic or translational laboratory research have a broad array of possibilities with formal courses and a richly supportive environment. Each trainee will have an individual oversight committee to review progress and provide feedback. Graduates of the program will have a productive research program and be fully prepared for a junior faculty position and ideally trained to successfully apply for NIH funding.
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