Alcohol Liver Center

The Massachusetts General Hospital Alcohol Liver Center, within the Digestive Healthcare Center strives to advance the care of patients with alcohol-related liver disease, a leading cause of liver disease, through clinical and research innovation.

Liver disease caused by alcohol use is very common and affects people from all walks of life. Alcohol has the potential to cause a wide spectrum of disease in the liver, including advanced liver disease and cirrhosis. For this reason, appropriate identification and active management of alcohol-related liver disease is paramount.

The Mass General Alcohol Liver Center takes a comprehensive, multidisciplinary approach to the clinical care of patients with alcohol-related liver disease. Our team consists of:

• liver specialists (hepatologists)
• addiction medicine physicians
• specialized nurses
• social work

All our team members work together to provide the best possible to care our patients.

Additionally, the Mass General Alcohol Liver Center is dedicated to research advancing the understanding of the causes of alcohol-related liver disease and improving therapies to prevent and treat alcohol-related liver disease. Our research program spans the spectrum of clinical, translational and basic science work and includes prominent investigators committed to defeating this disease.

Clinical Program

Our multidisciplinary outpatient clinic includes evaluation by a hepatologist and addiction medicine physician, who work collaboratively to develop a comprehensive care plan. Additionally, we have on-site access to FibroScan, which allows for non-invasive assessment for liver fibrosis.

Our inpatient consultation team sees patients admitted to the hospital who have a history of alcohol use and who also may be at high risk for liver disease. Through a combination of clinical evaluation, laboratory assessment, radiology tests and possibly liver biopsy, our team is able to make appropriate clinical recommendations.

Our clinical teams also incorporate addiction medicine fellows and gastroenterology fellows.

Research Program

The Mass General Alcohol Liver Center is also dedicated to research advancing the understanding of the causes of alcohol-related liver disease and improving therapies to prevent and treat alcohol-related liver disease. Our research program spans the spectrum of clinical, translational and basic science work and includes prominent investigators committed to defeating this disease.

Current projects include:

1. Establishment of a biorepository that includes patient data representing a wide spectrum of patients with alcohol-related liver disease
2. Biomarker discovery
3. Understanding the role of metabolism and immunity in contributing to liver injury from alcohol
4. Clinical trials of novel therapeutic agents

Our investigators are supported by several organizations, including the National Institutes of Health, the pharmaceutical industry and the American Association for the Study of Liver Diseases.

For Health Care Professionals

The Mass General Alcohol Liver Center is committed to sharing our experiences with all health care professionals. We plan to hold an annual conference for health care professionals, covering current clinical and research progress in the field. Additionally, we are available to perform consultations in a timely and efficient manner. To request a consultation, please call our office at 617-724-6004. 

Patient Education

Please visit our site for updates.

Research and Publications

Interrelationship Between Coronavirus Infection and Liver Disease

Liver injury in the setting of COVID‐19–related illness poses a unique challenge to the clinician. First, there is often uncertainty whether there is preexisting undiagnosed liver disease. Second, many of the medications used to treat moderate and severe disease have their own profiles of liver toxicity. Finally, in the subset of patients who experience critical illness, multiple factors may influence the trajectory of liver injury.

A review drafted by Esperance A. K. Schaefer, MD, MPH, summarizes what is known about liver injury in COVID‐19 and provide diagnostic clues to contributing factors to the liver biochemical profile. The senior author on the review is Raymond T. Chung, MD. The review is published in Clinical Liver Disease.

Liver Biochemistries in Hospitalized Patients With COVID‐19

Coronavirus disease 2019 (COVID‐19) leads to elevated liver biochemistries in approximately half of patients on presentation. To date, data are limited regarding the trend of liver biochemistries over the course of illness.

A study led by Patricia P. Bloom, MD, aimed to evaluate the trend, etiology, and outcomes associated with liver biochemistries in COVID‐19. The senior author is Raymond T. Chung, MD. Their research is published in Hepatology.

Mass General Researchers Find Potential Drug Treatment Targets for Alcohol-related Liver Disease

Alcohol-related liver disease (ALD) is a deadly condition affecting more than 150 million people worldwide with no treatment available besides transplant.

But now, a team led by researchers from Massachusetts General Hospital has uncovered key molecular step stones in ALD that may provide targets for drug therapy development. Their work was recently published in Proceedings of the National Academy of Sciences. The lead author of the study is Jay Luther, MD, gastroenterologist and Director of the Mass General Alcohol Liver Center. The senior author is Suraj J. Patel, MD, PhD, a research fellow in the Department of Medicine.

Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity

Alcohol and drug use results in substantial morbidity, mortality, and cost. Individuals with alcohol and drug use disorders are overrepresented in general medical settings. Hospital-based interventions offer an opportunity to engage with a vulnerable population that may not otherwise seek treatment.

A study led by Sarah E. Wakeman, MD, sought to determine whether inpatient addiction consultation improves substance use outcomes 1 month after discharge. Nancy A. Rigotti, MD, was the senior author on the study. Their research is published in the Journal of General Internal Medicine.

Effect of Integrating Substance Use Disorder Treatment into Primary Care on Inpatient and Emergency Department Utilization

Components of substance use disorder(SUD) treatment have been shown to reduce inpatient and emergency department (ED) utilization. However, integrated treatment using pharmacotherapy and recovery coaches in primary care has not been studied.

A study led by Sarah E. Wakeman, MD, sought to determine whether integrated addiction treatment in primary care reduces inpatient and ED utilization and improves outpatient engagement. Joshua P. Metlay, MD, PhD, was the senior author on the study. Their research is published in the Journal of General Internal Medicine.

Understanding why patients with substance use disorders leave the hospital against medical advice: A qualitative study

Hospital discharges against medical advice (AMA) is associated with negative health outcomes and re-admissions. Patients with substance use disorders (SUD) are up to three times more likely to be discharged AMA as compared to those without SUD. Studies suggest that undertreated withdrawal and a perception of stigma may increase the risk, however, to date, there are no published qualitative studies exploring the specific reasons why patients with SUD leave prematurely.

A study conducted by Rachel Simon, MD, Rachel Snow, MA, and Sarah Wakeman, MD, shed light on the reasons patients with SUD are discharged from the hospital AMA, and support the need for inpatient addiction treatment, particularly for management of withdrawal and co-occurring pain, and the need to address health care provider associated stigma surrounding addiction. Their research is published in Substance Abuse.