Roberto J Groszmann MD
Professor Emeritus of Medicine (Digestive Diseases)
Ascites; Cirrhosis; Portal Hypertension; Variceal Bleeding
The most common and lethal complications of cirrhosis are related to the development of portal hypertension. Half of the deaths from cirrhosis are related to gastrointestinal bleeding due to portal hypertension. The studies performed in our laboratory on different models of portal hypertension as well as in patients with chronic liver diseases and portal hypertension, allow us to focus on those questions that are key to a thorough understanding to the pathophysiology of portal hypertension and its logical treatment. Contributions from our laboratory to the field of portal hypertension have included recognition of 1) the significance of increased splanchnic blood flow in contributing to the severity of portal hypertension, 2) the role of plasma volume expansion in aggravating the severity of portal hypertension, 3) the role of nitric oxide in portal hypertension 4) the development of new animal models and techniques for studying the pathophysiology and effects of therapy in portal hypertension. In the clinical area, 1) the mechanisms leading to variceal rupture, 2) the introduction of nitrates to the treatment of portal hypertension, 3) the potential benefits of various drugs combinations in treating portal hypertensive patients and 4) clinical trials in order to explore the knowledge acquired in the laboratory.
During the course of training, the research fellow becomes familiar with techniques to study splanchnic and systemic hemodynamics in patients and animal models of portal hypertension. Also, they become proficient in principles and techniques to study vascular physiology and pathophysiology at the cellular as well as the molecular level, in the portal and intrahepatic circulation. Fellows interested in clinical research can become involved in the organization and development of multicenter clinical trials.