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					                                                 American Liver Foundation Connecticut Chapter

                                                        Fund-A-Grant Speaker John Norman and his family.

   Live Information
For Everyone

 June 2008
 Vol. 25 Issue 2

 In This Issue:
                                      Chapter News:
 Letter from the President       2    Flavors of CT raises $170,000
 Recurrence of Hep C after       5    Flavors of Connecticut, held April 1st,     Tequila Bar and Paul Morbidelli;
 transplants                          was another astounding, sold-out event Ibiza and Manuel Romero Sendon; Il
                                      this year, bringing in more than            Palio and Jeff Urban; Jasper White's
 Alcohol and your liver          7
                                      $170,000 for liver research and educa-      Summer Shack and David Parr;
 Speakers Bureau expands         9
                                      tion.                                                              Johnny Ray's and
                                      ALF and guests                                                     Michael
                                      welcomed 30                        The New Mill won
 CT ALF executive director       9                                                                       Mastrianni;
                                                                  “Most Imaginitave Tablescape .”
 honored                              restaurants and                                                    Mickey's and
                                      chefs to the event                                                 Mickey Josephs;
 Clinical trials enrolling now   10   at the Aqua Turf                                                   Mohegan Sun
                                      Club in                                                            and Michael
                                      Southington. They                                                  Luboff, Jeff
                                      included Antonio's                                                 Steelman,
                                      Ristorante and Gina                                                Richard
                                      Colavolpe-Dilegge;                                                 Doucette, Aiman
                                      Barcelona                                                          Saad, James
                                      Restaurant and                                                     Klewin, Widodo
                                      Pedro Garzon; Bee                                                  Wijaya and Lynn
                                      & Thistle Inn and                                                  Mansel; New
                                      Kristofer Rowe;                                                    Mill and Bob
                                      Bespoke & Sabor                                                    Martucci; One
                                      and Arturo Franco                                                  Bellevue at Hotel
                                      Camacho; Bin 100                                                   Viking and Kevin
                                      and Frank                                                          Thiele; Simmer
                                      Altomare; Bocca                                                    Restaurant and
                                      and Terry Noyes; Café Goodfellas and        Bobby Mundell and Scott Martin;
                                      Gerry Iannaccone; Copper Beech Inn          Stillwater American Bistro and Joe
                                      and Francois de Melogue; Firebox and        Dunleavy; Thali and Prasad
                                      Jason Collin; Forbidden City Bistro and Chirnomula; The Stone House and
                                      Mario Wongsosudrio/Johnathan Khoo;          Peter Hamme; Tre Scalini and Arturo
                                      Fosters and David Foster; Geronimo           Please turn to Page 4
                                                                                                ALF awards ’08 grants
                                                                                                to liver researchers
Letter from                                                                                     Each year the American Liver Foundation
                                                                                                funds research as part of its overall effort to
                                                                                                prevent, treat and cure hepatitis and other

                        the board president                                                     liver diseases. Since its inception in 1979,
                                                                                                ALF's Research Awards Program has provid-
                                                                                                ed almost $21 million to scientists engaged
Dear Friends,                                                                                   in liver research.
                                                                                                The current awards and the reasearchers’
As usual the Connecticut Chapter of the American Liver Foundation is a beehive of activity      topics are listed below:
planning events and activities that support our mission statement to promote liver health
and disease prevention through research, education and advocacy for those affected by           2008 Research Awards
liver-related diseases, including hepatitis. Following is a brief summary of our events since   American Liver Foundation Liver Scholar
January.                                                                                             .
                                                                                                Lee F Peng, MD, PhD
                                                                                                Massachusetts General Hospital, Boston, MA
The Connecticut Chapter hosted almost 400 people at the Aqua                                    Discovery, Design and Characterization of
Turf on April 1st at its' signature event, the 7th Annual Flavors of                            Modulators of Hepatitis C Virus Replication
Connecticut. Those who attended were treated to a delicious
five-course dinner. Attendees also had a chance to bid on silent                                New England Run for Research Liver Scholar
and live auction items as well as an opportunity to contribute to a                             Songling Liu, MD
fund-a-grant.                                                                                   University of Texas Southwestern Medical
This event raised more than $170,000 for research! Thank you to                                 Center, Dallas, TX
Flavors co-chairs Agnieszka Buller and Leslie Ann Powers, the                                   Post-translational Regulation of Sinisoidal
committee, volunteers, Flavor chefs and ALF staff for making this                               Endothelial Cell eNOS by the GPCR
a successful event.                                                                             Interacting Protein GIT 1

On March 1st the community Liver Update was held at Wesleyan University. The theme of           American Association for the Study of Liver
this educational program was “Living Well with Liver Disease.” A Liver Update for health        Diseases Liver Scholar
professionals was held on April 26th in Mystic. In addition a symposium on liver cancer         Costica Aloman, MD
was held in Westport on February 25th. The Connecticut Chapters' outreach program               Mount Sinai Medical School Mount Sinai
called “Treatment Choices Initiative” (TCI) under the leadership of Phil Scarfo has proven      Hospital, New York, NY
to be hugely successful. The program trains volunteers to speak and offer support to com-       Modulation of Liver Fibrosis by Dendritic
munity groups on hepatitis C. Since September 2007, when the program was launched,              Cells
1,309 people have participated.
                                                                                                2008 Special Research Initiatives
In regard to advocacy, Tom Reilly organized a Hepatitis Awareness Campaign in May, which                  .
                                                                                                Thomas F Nealon, III Biliary Atresia Special
is designated Hepatitis Awareness Month. He reached the CTALF membership through                Research Initiative, honoring Zachary Rue
Constant Contact, encouraging people to write to their state senators and representatives to    Jane Huiru Wang, MD, PhD
make them aware of the impact of liver disease and hepatitis in the state. Please be on the     Northwestern University, Feinberg School of
lookout for information in October to help us support Liver Awareness Month. Remember           Medicine, Chicago, IL
all of us who are touched by liver disease have a responsibility to educate and advocate        Molecular Mimicry in Pathogenesis of
about liver disease and hepatitis.                                                              Biliary Atresia

I encourage people to go to the American Liver Foundation Web site www.liverfounda-             Primary Biliary Cirrhosis Special Research Here you will find information for patients, caregivers and profes-    Initiative
sionals. Area resources, clinical trials, Chapter news and updates including a list of events   Joseph J. Palermo, Jr., MD, PhD
and programs are listed.                                                                        Washington University, St. Louis, MO
                                                                                                Role of Recurrent Urinary Tract Infection in
A note of interest, the American Liver Foundation was named the charity of choice by            Immune Mediated Cholangiopathy
Sugarland, the country singers who won the Duo Video of the Year honor at Country Music
Television's 2008 Music Awards.                                                                 2008 Postdoctoral Research Fellowships
                                                                                                Irwin M. Arias, MD Postdoctoral Research
The success of the Connecticut Chapter is due to the support, tireless work and commit-         Fellowship
ment of our volunteers, committees, board members and staff. It is because we pull togeth-      Sergio A. Gradilone, PhD
er under the guidance of JoAnn Thompson, executive director, and her staff that this hap-       Continued on Page 9
pens. All of you deserve a pat on the back and a big THANK YOU!

Wishing you a happy and safe summer,
Reggie Belmont
President of the CTALF Board of Directors                                                       Sponsor of this edition of the CTALF newsletter.

                                                       June 2008 Page 2
Chapter News:
                    7/11/2008                                                         Rally a team for Liver Life Walk
                  Transplant Games                                                    The 2008 Liver Life Walk,       woman. Jecy Belmont, a
                  The U.S. Transplant Games presented by the National Kidney          formerly known as the           manger at CT Laser, is
                  Foundation will be held July 11th-16th in Pittsburgh. Events
                                                                                      Football Walk for Liver         Walk ambassador, and
                  are planned for all ages and athletic abilities, including a 5k
                                                                                      Wellness, will take                     Hanna Clark,
                  walk. Contact Kim Hathaway 1-800-441-1280.
                                                                                      place on Sept. 14                          whose Hanna
                                                                                      at Rentschler                               Banana team
                  Stacia Mabry Memorial Golf Classic
                  Enjoy a day in the sun with friends at Mohegan Sun’s private
                                                                                      Field in East                               made a splash at
                  County Club at Pautipaug while supporting the ALF .                 Hartford, home                             the 2007 Walk, is
                                                                                      field of the UConn                      junior ambassador.
                  Liver Life Walk Team Captain Kickoff                                Huskies. Last year’s walk       The Chapter will hold a
                  Join us for breakfast at 9:30 a.m., Rentschler Field, in East       drew 1,200 participants         Kickoff Breakfast at 9:30
                  Hartford.                                                           and raised $107,000 for         a.m. July 19th at
                  Do it for yourself and a worthy cause! Learn how to be a            liver disease education         Rentschler Field. We’ll
                  team captain and fundraising tips for the big day from past         and research.                   provide info on the ALF ,
                  captains.                                                           This year, Martha Shea          tips on team-building and
                    9/14/2008                                                         RN of the Hepatitis C           fundraising, and raffle
                                                                                      Research Center at the VA       prizes. Register today as a
                  Liver Life Walk
                  Looking for motivation to get you off the couch? Help raise
                                                                                      Medical Center in West          sponsor, a team captain or
                  money and awareness by joining us for day of entertainment,         Haven is chairwoman of          an individual walker by
                  prizes, snacks and exercise. Raise $100 for a free Walk shirt!      the Walk. Alison                contacting Marla Hannah
                                                                                      Cubbellotti of Trumbull, a      Sadler at (203) 234-2022
                                                                                      student at Sacred Heart         or msadler@liverfounda-
                  Professional Liver Update
                  A Liver Update for healthcare professionals will be held in
                                                                                      University, is junior chair-
                  the Bridgeport area in early fall at a date and location to be
                  anounced. Topics will include hepatitis C, fatty liver disease
                  and liver cancer. For more information, contact Tom Reilly
                  at (203) 234-2022 or, or check
                  the Web site:
Upcoming Events


                  Flavors of CT Fairfield County                                      Martha Shea, Alison Cubbellotti, Jecy Belmont and Hanna Clark.
                  Treat yourself to a unique culinary experience: A chef from
                  one of Fairfield County's most prestigious restaurants cook-
                  ing tableside for you and nine friends.                             Join us at 6th Annual Golf Classic
                                                                                      The 2008 Stacia Mabry          Stacia Mabry, who, in 2004
                  Sun Wine Fest ‘09                                                   Memorial Golf Classic          at only 18, died of Wilson’s
                  New England’s 6th Annual Sun WineFest, a world-class wine           will be held July                          disease, a rare
                  and food experience, will be held Jan. 17th and 18th, 2009,
                                                                                      14th at the                                liver disease.
                  at Mohegan Sun. The 6th Annual Grand
                  Tasting, noon to 5 p.m. Saturday and Sunday,
                                                                                      Mohegan Sun                                Sponsors this
                  and the Saturday Evening Celebrity Chef                             Country Club at                            year include the
                  Dine Around will benefit ALF .                                      Pautipaug.                                 Mohegan Sun
                                                                                      Registration is                            Tribe and the
                  Flavors of Connecticut 2009                                         at 11 a.m.,                                Mohegan Sun
                                                                                                             Stacia Mabry
                  Mark your calendar now for next year’s gala Flavors of              lunch at noon,                             Casino.
                  Connecticut. It will be held March 31st, 2009, at the Aqua          and tee off at 1 p.m. A        To register your foursome
                  Turf Club in Southington. Dr. Renuka Umashanker is chair-           reception, raffle and          or become a sponsor,
                  woman.                                                              awards dinner will follow please contact Event
                  For more information on these events, contact Event                 the tournament.                Coordinator Marla Hannah
                  Coordinator Marla Hannah Sadler, (203) 234-2022 or                  David Lathrop Sr. is           Sadler at (203) 234-2022
                                                chairman of the event. He or msadler@liverfounda-
                                                                                      is the grandfather of
                                                                   June 2008 Page 3
Flavors of CT                                                                                          Photography by

                                                                                                        Arturo Franco Camacho of

raises $170,000                                                                                         Bespoke & Sabor

Continued From Page 1

Moreno; Union League Café and Jean-Pierre Vuillermet and
Matthew Redington; and the Woodbridge Country Club and Ryan
Trevethan. Guests were wowed by the original table designs and
decorations. However, this was only the beginning of the evening.           Co-Chairwomen
                                                                         Agnieszka Buller and
As promised, the talented chefs once again provided exquisite             Leslie Ann Powers
meals, from the “best hors d'oeurves ever,” to imaginative courses
and wine pairings. WFSB Chanel 3’s Al Terzi was emcee, and
reception hosts included Aqua Panna & San Pellegrino, Cabot                                                    The Simmer table
Creamery, Metz USA, Northeast Wine Brokers and Tommy
Bahama Ultra Premium Rum. A duo from Eight to the Bar
provided the music.
Professional Auctioneer Paul Stansel led the live auction por-
tion of the evening, which featured a limousine trip to New
York City for a taping of “Iron Chef America,” a picnic on a
corporate yacht, a chance to be a sous chef for a day, VIP tick-
ets the Macy’s Day parade and spa vacations at the Canyon
Ranch.                                                                    Prasad of Thali
The Fund-A-Grant presentation was led by ’07 liver transplant
recipient John Norman and his family, who shared their per-
                                                                        The chefs and CT ALF Event Coordinator Marla Hannah Sadler
sonal struggles with liver disease and dedication to the
American Liver Foundation.
This year’s table designs were sensational! Congratulations to
all of our winners. On behalf of the entire organization, we
would like to thank Co-chairwomen Agnieszka Buller and
Leslie Ann Powers, Chef Chairman Todd Lyon, and the
Flavors of CT committee for their hard work and dedication.
We also would like to thank our Platinum Sponsor, Mr. and
Mrs. Jeffrey Belmont, for their support; as well as Gourmet
Table Sponsors Bayer, Bristol Myers-Squibb, Connecticut
Gastroenterology Associates, Connecticut Gastroenterology
Consultants, Connecticut Gastroenterology & Medical
Associates, Digestive Disease Consultants, Gastroenterology
Center of CT, Hartford Anesthesiologists, Hartford Hospital,
Litchfield Gastroenterology Group, Pentax, Roche, Three
Rivers Pharma, Yale-New Haven
                                                                                    The “Overall Best Table” Award went to Tre Scalini
Hospital, Yale-New Haven
Transplantation Center, Yale
                                           Table Creativity Awards                                    of New Haven

Section of Digestive Diseases and          Overall Award:
Yale University School of Medicine,
                                           Tre Scalini, New Haven
Department of Pediatrics. Thank
you, too, to all of our fabulous           Most Innovative Design:
Flavors restaurants and chefs, table       Simmer Restaurant & Lounge,
designers, tireless volunteers and         Canton
wonderful guests.
We are already taking reservations         Best Floral Design:
for next year's event, which will           Bee & Thistle Inn, Old Lyme
take place March 31, 2009, at the          Most Innovative Tablescape:
Aqua Turf Club. Reserve your               New Mill Restaurant,
table now so you don't miss this           Plantsville
truly one-of-a-kind gastronomic
                                                                 June 2008 Page 4
 Hepatitis C Recurrence Common After Transplant
By George G. Abdelsayed, MD, FACP, FACG        One of the most daunting tasks of the             virus material and a liver biopsy that
                                               transplant hepatologist is to distinguish         shows characteristic features. As already
Hepatitis C virus (HCV) currently affects      recurrent hepatitis C from the numerous           mentioned, distinguishing between
5 million Americans in the U.S. and is         causes of graft dys-                              recurrent HCV and other diagnoses
the leading reason for liver transplanta-      function; the latter                              (especially graft rejection) can be chal-
tion (second-leading cause in Europe).         may include infec-                                lenging.
While Orthotopic (Cadaver) Liver               tions (early and late),
                                               primary nonfunction,                              Is it treatable?
Transplantation (OLT) has offered a great
                                                                                                 Treatment of post-transplant HCV is dif-
deal of hope for improved survival in          hyperacute and acute
                                                                                                 ficult and is fraught with obstacles,
most patients, recurrence of the virus is      rejection. The wide
                                                                                                 including poor response and higher dis-
almost universal. This is in contradis-        utilization of “proto-
                                                                                                 continuation of medications due to side
tinction to diseases that rarely recur after   col” allograft biopsies
                                                                                                 effects. The most effective treatment is
transplantation, such as Wilson's disease      -- that is, biopsies      George Abdelsayed, MD
                                                                                                 pegylated interferon injections (a mole-
and Glycogen storage diseases. Hepatitis       performed at frequent
                                                                                                 cule that stays in the body for almost one
C will recur in 95% of patients after          intervals -- has streamlined the process
                                                                                                 week) and ribavirin (an antiviral agent).
transplantation, as blood cells (mono-         of follow up of the health of the graft.
                                                                                                 The durable response (called Sustained
cytes) in the circulation infect the graft     Liver biopsy (preferably by way of a nee-
                                                                                                 Virologic Responses or SVR) is on the
(the transplanted liver) rapidly. Graft        dle technique) is the single most reliable
                                                                                                 order of 40%, and is significantly better
reinfection may be detected as early as        method to determine the cause of liver
                                                                                                 than if each agent is given alone. Giving
days to weeks following transplantation,       disease in the post-transplant period.
                                                                                                              these agents for prevention
and this may be reflected as
                                                                                                              (prophylactic or preemptively)
elevation in viral load.
Although the amount of virus
                                    Aggressive disease management                                             is somewhat controversial but
                                                                                                              has been effective in some
circulating in the body may
fluctuate post transplant, they
                                     prior to transplantation offers                                          studies. Retransplantation
                                                                                                              (including HCV infected
tend to be higher (up to 10 to              the best hope for                                                 grafts) may be done, but there
20 fold) than pretransplant
levels and to peak at three               reducing recurrence.                                                are severe restrictions on can-
                                                                                                              didacy, and results, although
months post transplant. More
                                                                                                              improving, are not universally
than two-thirds of such patients will          Most studies suggest that liver biopsy
have biopsy evidence of hepatitis, which       may be performed as safely in the trans-
may progress over years, with conse-           plant patient as in the non-transplant            In summary, HCV is the leading cause of
quent reduction in graft and patient sur-      patient.                                          liver transplantation in the United States.
vival.                                                                                           Recurrences are very common (greater
                                               What form does it take?
                                                                                                 than 90%), but outcomes are variable,
Why does Hep C recur?                          Recurrent HCV post transplant manifests
                                                                                                 with 20% to 40% progressing to cirrhosis
There are several factors, which are not       as one of three possible scenarios:
                                                                                                 slowly over five to 10 years and 5% to
completely understood, that influence          a) Moderate liver enzyme (called
                                                                                                 10% progressing to rapid graft failure and
the recurrence of HCV following liver          Aminotransteases) elevation with pro-
                                                                                                 possible death. Treatment is limited to a
transplantation; they include donor and        gression of disease over five to 10 years
                                                                                                 combination of pegylated interferons and
virus factors as well as factors relating to   (20% to 40%)
                                                                                                 ribavirin or, in a select group of patients,
the immune system. For example, adult-         b) Mild-to-moderate enzyme elevation
                                                                                                 retransplantation. Aggressive disease
to-adult transplantation, especially where     and some inflammation seen on liver
                                                                                                 management prior to transplantation
the donor age is older (70 to 80 years of      biopsy (about 20%).
                                                                                                 offers the best hope for reducing recur-
age), may be associated with more severe       c) Mild-to-moderate enzyme elevation
recurrences. HCV genotype 1b may be            with moderate inflammation seen on
associated with more frequent recur-           liver biopsy (about 50%).                         Dr. Abdelsayed is section chief and direc-
rence. It is also unclear whether a higher     d) A severe and rapidly progressive               tor for the gastroenterology program at
viral load before transplantation (called      destruction (called fibrosing cholestatic         Bridgeport Hospital, and a clinical assis-
pretransplant viral load) may be associat-     hepatitis) resulting in cirrhosis and             tant professor of medicine at Yale
ed with more persistent disease post           death from liver failure, sometimes with-         University School of Medicine.
transplant. The use of high-dose (bolus)       in one year (about 5% to 10%).
steroids and other high-intensity
immunosupression regimens (which are           How is it diagnosed?                                      Visit the ALF Web site:
necessary to protect the graft) likely         The diagnosis of post-transplant HCV
result in more severe disease recurrences.     rests upon demonstration of circulating
                                                          June 2008 Page 5
Drive public support for organ donation                                                    Workplace giving, toys and cars
                                                                                           will help support liver programs
The Connecticut Department of                35 percent of licensed drivers in             Here are three easy ways to help CTALF :
Motor Vehicles will issue “Donate            Connecticut are organ and tissue
                                                                                           Give at Work
Life” license plates if it receives appli-   donors.
cations from owners of 400 registered        The group hopes “Donate Life” license         The Community Health Charities of
vehicles. LifeChoice Donor Services,         plates will help spur more people to          Connecticut (CHCCT), a federation that has
based in Windsor, is spearhead-                        register.                           been raising awareness and funds for the
ing the drive in an effort                               The DMV charges a one-            state's most crucial health charities for 40
to raise public awareness                                time fee of $65 to replace an     years, organizes
of the need for organ                                    existing marker plate with a      worksite giving
donors.                                                  special-interest plate. For       campaigns. They
Nationally, nearly                                        vanity plates, that charge is    are easy to estab-
100,000 people are wait-                                  $130. Regular registration       lish and main-
ing for organ transplants.                                         fees also apply.        tain. If you’d
Approximately 750                                                   LifeChoice will        like to learn how to get one started, please
Connecticut                                                        not receive any         contact CHCCT at (800) 344-6071 or visit
residents are                                                     money from the 
among them.                                                    DonateLife project, but     Pass along a stuffed animal
Each week                                                  hopes to benefit from           CTALF gussies up and resells clean, lightly
one of them                                  increased public awareness. In the            used stuffed animals. They may be mailed to
dies simply because an organ is not          event fewer than 400 DonateLife plates        or dropped off at the CTALF office, 127
available. Donate Life Connecticut, a        are ordered, applicants checks will be        Washington Ave., Second Floor, North Haven,
coalition of healthcare advocacy             returned.                                     06473.
organizations, professionals and indi-       For a DonateLife license-plate applica-
                                                                                           Donate an old or disabled car
viduals dedicated to increasing public       tion, please call 860-286-3132.
                                                                                           CTALF will even arrange to pick it up. It must
education and awareness about the            For more information about organ and
                                                                                                                 be whole, but it needn’t
benefits of organ and tissue donation,       tissue donation AND how you can reg-
                                                                                                                 run. For details on the
is working to change those statistics.       ister your wish to become an organ and
                                                                                                                 Natioanl Vehicle Donation
One person’s decision to be an organ         tissue donor, please visit www.ctor-
                                                                                                                 Program or to donate a
donor can save and enhance the lives or call 203-
                                                                                                                 car, call (203) 234-2022.
of more than 50 people. Currently,           387-1549.
   Support Groups

                     Liver Disease Support Group             Hepatitis C                            UConn Health Center
                                                             WEST HAVEN                             FARMINGTON
                     NORTH HAVEN                                                                    The Central Connecticut Hepatitis
                     This group meets 10 a.m. to noon        The Hepatitis C Research Center at
                                                                                                    Community meets the second
                     on scheduled Saturdays (call for        the VAMC in West Haven invites
                                                                                                    Wednesday of each month from 7 - 9
                     dates) at the CTALF office, 127         veterans and their families to meet
                                                                                                    p.m. at UConn Health Center,
                     Washington Ave., North Haven. It        on the fourth Thursday of each
                                                                                                    Research Building, Room EG103.
                     offers education and support for        month from 7 - 8:30 p.m. at the
                                                                                                    Medical liaisons are George Y. Wu,
                     people with any liver disease and       VAMC Hep C Center, 4th Floor,
                                                                                                    M.D., Ph.D. and Chidinma Byron,
                     their families. Contact Reggie          950 Campbell Ave., West Haven.
                                                                                                    APRN 860-679-4260.
                     Belmont at 203-439-0888 or e-mail       Contact: Martha (203) 932-5711
                                                                                                    At the Sept. 10 meeting, Dr. Wu will
                                 ext. 5338.
                                                                                                    give updates on HCV drugs in the
                                                                                                    pipeline and the current clinical trials
                     Transplant Patients                     Midstate Medical Center                at UConn Health Center.
                     GLASTONBURY                             MERIDEN                                For information, contact Adrian
                     Open to transplant recipients and       This free program is an opportuni-     McIveen via email at chcgroup@sbc-
                     their families, as well as patients     ty for patients in treatment or con- or call Martin Thayer at
                     awaiting transplantation, this group    sidering treatment and their care-     860-628-9750.
                     provides education, social, and other   givers to discuss personal experi-
                     supportive services. Sponsored by       ences and concerns regarding the        Stay up to date on ALF
                     Hartford Hospital, the group meets at   disease and treatment for HCV.
                     the First Church of Christ              Group meets at the Horowitz             programs and events, and
                     Congregational at 2183 Main St.,        Conference Center,                      find information on liver
                     Glastonbury, on the fourth Thursday     Conference Room 1. Dates to be          disease at
                     of each month at 7 p.m. Contact         announced. For more information
                     John McNab or Colleen Brown at          contact Kathryn Jack, APRN, at  
                     (860) 545-2142.                         (203) 886-0036, ext. 217.

                                                              June 2008 Page 6
Alcohol and liver transplantation
By Dr. Cary Caldwell                            behaviors of the heavy drinker but also the     alcohol cirrhosis is prevention. There is
                                                different attitudes of society towards the      interindividual variability between alcohol
“Elementary my dear Watson,” a phrase           drinker. The jovial lush in Henry IV is         consumption and liver injury, partly
possibly first uttered by the Connecticut       entertaining and engaging, while the trage-     explained by gender and race, but also by
stage actor William Gillette, was certainly     dian in Under the Volcano is withdrawn and      genetic polymorphisms or differences in
not a reference to the poisonous aspect of      isolated. Falstaff's humorous inebriation       the enzymatic degradation of alcohol,
alcohol. However, the elemental arrange-        was acceptable and Firmin’s was scorned.        mutations in the production of tumor
ment of carbon,                                 “Despite offers of a sober and non-alcoholic    necrosis factor, etc. The end result is the
hydrogen and oxygen                             Paradise,” Lowry's ex-British consul            formation of fibrosis or scarring, noted
is both a poison and                            imbibed until his death. Yet the story of       grossly as hepatomegaly and microscopi-
a pleasure. From the                            both these literary characters is tragic, as    cally as the presence of fibrotic bands
earliest fermentation                           the alcohol was an escape and an end -- a       becoming confluent throughout the liver.
in human history,                               dead end with Firmin.                           The consequence of cirrhosis is conges-
the euphoria of                                                                                 tion of the venous circulation to the liver,
ethanol has been                                Effects on the body                             namely the portal vein. The liver is a
realized. In small                              The toxicity of alcohol is not only psy-        unique organ in many ways -- first,
measure, alcohol can                            chosocial but also physiologic. Upon entry      because there can be some reversibility of
be tasteful and              C. Caldwell, MD    into the stomach, the alcoholic beverage        damage, such as in the case with alcohol
innocuous, but                                  can be directly caustic to the gastric mucos-   hepatitis; and second, because its predom-
because of a narrow therapeutic window, it      al. Rapid degradation occurs via alcohol        inant feeding vessel is the portal vein,
can also be extremely toxic. This straight-     dehydrogenase, an enzyme that has gender        supplying 70% of the liver's blood supply.
chain alcohol has impacted mankind since        and racial differences. This, in part,          While other organs are perfused exclu-
ancient times and affects modern society in     explains a higher blood-alcohol in women        sively by arterial circulation, the liver is
many ways; economically, psychosocially         than in men, accounting for weight adjust-      supplied by the hepatic artery and the
and medically. Alcohol liver dis-                                                                       portal vein. With portal hyperten-
ease remains among the leading
indications for liver transplanta-
                                     “The best treatment of alcohol                                     sion, there are the sequelae of
                                                                                                        varices and ascites.
The vast variety of alcohol, from
                                        cirrhosis is prevention.”                                       Esophageal and gastric varices,
                                                                                                        while analogous to varicose veins
a fine wine to the sweet summer specialty       ment. Other theories include female hor-        of the lower extremities, are vastly differ-
of a microbrewery and the subzero liquidity     mone-related effects and gender differences     ent. Varicose veins are a cosmetic prob-
of vodka, provides the endless appeal for a     in alcohol bioavailability. Aside from alco-    lem; varices are a catastrophic problem.
product with annual sales of almost $116        hol dehydrogenase, another enzyme that          Bleeding from esophageal varices heralds
billion, a according to the Economic            metabolizes alcohol is cytochrome 2E1           a high mortality rate and is one of the
Research Service of the USDA. The eco-          (CYP2E1). This enzyme is also responsible       indications for liver transplantation.
nomic burden of alcohol on society is           for the metabolism of other compounds           Medical and endoscopic therapy, stenting
equally high, from expenditures on medical      and medications, including acetaminophen.       by interventional radiology, and surgical
treatment, loss of work productivity, and       In most individuals under normal circum-        shunting also can be helpful in the treat-
premature death. In 1998, the National          stances, the alcohol dehydrogenase path-        ment of variceal bleeding.
Institute of Alcohol Abuse and Alcoholism       way is dominant. However in alcoholics or       Ascites, from the ancient Greek askos for
estimated that annual cost at $184 billion.     in people with high blood-alcohol levels,       vessel or pot, is the presence of fluid with-
And the emotional cost is immeasurable,         the CYP2E1 is induced and is predominant.       in the peritoneal cavity. This arises from
for it is the family of an alcoholic that is    It is for this reason that acetaminophen        cirrhosis of the liver and, rarely, from
affected for a generation or more.              usage in chronic alcoholics can be danger-      thrombosis of the hepatic vasculature,
                                                ous, as rapid production of toxic metabo-       malignancy and other causes. The pres-
A fixture in society                            lites occur that adversely affect the liver.    ence of refractory ascites or fluid that per-
The consumption of alcohol can denote the                                                       sists despite the usage of diuretics or in
ascent to adulthood, the milestone of mar-      Liver injury                                    the presence of worsening renal failure,
riage, and the pride of professional achieve-   Alcohol injury to the liver consists of a       can be ominous. The gravity of this con-
ment. Ritualized in Communion or on the         spectrum of three phases: fatty liver, or the   dition has been known for centuries. St.
Sabbath, though absent in a Bodhisattva         deposition of fat droplets interspersed         Jerome, who died in 420, wrote, “Alius
vow or the Halal meal, the cup is variably      among hepatocytes; alcohol hepatitis, or        tumenti aqualiculo mortem parturit” -- “the
sipped worldwide. While alcohol is accept-      inflammatory changes of the liver; and cir-     one there with his swollen belly is preg-
ed in some, but not all, cultures and coun-     rhosis, or the end-stage appearance of          nant with his own death.” Indeed, once
tries, alcoholism knows no boundaries and       fibrosis. Alcohol fatty liver as an early       refractory ascites occurs, there is more
is omnipresent among religions.                 stage of injury can be reversible, as can       than a 50% mortality at one year. Thus,
The literary image of the alcoholic appears     alcohol hepatitis. However, cirrhosis is        refractory ascites is another strong indica-
as William Shakespeare's Falstaff and           rarely reversible, even with total abstinence   tion for liver transplantation.
Malcolm Lowry's Geoffrey Firmin. These          from alcohol. Thus, the best treatment of
                                                                                                Please turn to Page 8
two figures epitomize not only the different
                                                          June 2008 Page 7
Transplantation is half the battle for alcohol cirrhosis
Continued from Page 7
                                                 of applied physiology at Yale University        healthy new liver but also spiritual or psy-
Damage to other organs                           half a century ago, originated the phrase       chological health. The liver can be
In addition to its effects on the liver, alco-   “disease concept of alcoholism.” Although       replaced, but there must also be a replace-
hol has consequences in other organs.            earlier physicians, such as Benjamin Rush,      ment of old habits with new sobriety,
From head to toe, there can be neurologic        used the terms addiction and disease in ref-    which must begin before the operation, as
toxicity and gouty arthritis of the lower        erence to alcohol, it was Jellinek who both     most transplant centers worldwide follow
extremities. Neurologic injury includes          characterized and classified this disease       a guideline of six months of sobriety.
neuropathy, dementia and ataxia.                 based on interviews with members of             Since the sobriety mantra of “one day at a
Psychiatric disturbances can range from          Alcoholics Anonymous (AA). He identified        time” can be outpaced by the by rapidly
alcoholism to depression, anxiety and            five subtypes of alcohol abuse, from alpha      deteriorating condition of cirrhosis during
insomnia. There also can be endocrinolog-        to epsilon, based on the frequency of con-      this six-month period of abstinence, there
ical effects of chronic alcohol consumption      sumption and the physiologic and psycho-        may be a need for flexibility at some
leading to both elevated and lowered             logical dependency. In current practice,        transplant programs. Notably, the deci-
blood-sugar levels. Cardiovascular compli-       these terms are no longer commonly used         sion to transplant a patient with alcoholic
cations of alcohol include hypertension,         to describe heavy alcohol intake and alco-      liver disease is made by a multidiscipli-
hyperlipidemia, cardiomyopathy and cere-         holism. The nomenclature has been dis-          nary team with expertise in transplant
brovascular disease. Malnutrition can            tilled (pun intended) to alcohol abuse,         surgery and hepatology, social work, nurs-
occur from the substitution of the false         alcohol liver disease, and alcoholism.          ing, and psychology or psychiatry.
calories of alcohol for the other-                                                                              Alcohol rehabilitation, coun-
wise necessary nutrients.           “The liver can be replaced, but                                             seling from transplant social
Protein-calorie malnutrition and                                                                                workers, and overall good
deficiencies of calcium, iron,
phosphorous, zinc and the vita-
                                    there must also be a replacement                                            staff-patient relationships
                                                                                                                become vital to the alcoholic
mins B1, B2, B6, and D are the
typical deficiencies associated
                                    of old habits with new sobriety.”                                           in achieving and maintaining
with chronic alcohol intake.                     Recidivism risk and transplantation             It is the awareness and admission of the
The deleterious effect of alcohol on the         As alcohol liver disease (ALD) is the sec-      problem that begin the road to recovery.
liver and other organs is not present in all     ond most common indication for liver            The 12-step fellowship of AA remains a
individuals. It is imperative that patients      transplantation behind viral hepatitis, it      cornerstone in group therapy for achiev-
who are pregnant or alcohol-dependant            remains an important responsibility for the     ing sobriety, although there can be other
abstain from consuming alcohol. People           medical-surgical team to determine a            modalities of treatment for the alcoholic.
with cirrhosis or other chronic liver disease    patient’s candidacy for transplant. This        Rarely is sobriety ever instantaneous, but
are cautioned against it. The estimated risk     task rests on the assessment of alcohol         rather a gradual process for both the indi-
of developing cirrhosis in patients with         dependency and alcoholism as a risk for         vidual and family. In the words of AA co-
hepatitis C over a 20-year period is approx-     recidivism or recurrent alcohol usage fol-      founder Bill Wilson, “We claim spiritual
imately 20%. This may double to 40% over         lowing transplantation. The reported rates      progress rather than spiritual perfection.”
a 10-year time frame in those patients with      of recidivism approach 20% to 30% but           Ultimately, it is not the transplant itself
both hepatitis C and heavy alcohol con-          vary greatly, possibly because of its defini-   that cures the patient of alcohol cirrhosis
sumption.                                        tion, whether there is infrequent consump-      and alcoholism. Along the journey of
                                                 tion or recurrent alcohol liver disease.        recovery, it is also the willpower of the
Window shopping                                  Indeed, the latter does occur, but infre-       individual and the love of family and
The acceptable amount of alcohol con-            quently. Alcohol cirrhosis and alcoholism       friends that maintain sobriety. Malcom
sumption for a healthy person is highly          coexist but are not synonymous. Thus,           Lowry may have said it best in reference
individualized, contingent on pre-existing       there can be patients in need of a liver        to his alcoholic protagonist, “No se puede
medical conditions, genetics, gender, age,       transplant who have cirrhosis from alcohol      vivir sin ama” -- “one cannot live without
body mass index, and family history. The         and hepatitis C or who have cirrhosis from      love.”
constitution of a drink is 4 ounces of wine,     alcohol and another cause. A study at
12 ounces of beer, and 1¼ ounces of dis-                                                         Dr. Caldwell of CT GI Consultants is affili-
                                                 Washington University-Barnes Jewish
tilled or hard alcohol. The consumption of                                                       ated with Yale-New Haven Hospital and the
                                                 Hospital in 1997 showed a significant
60 to 80 grams of alcohol (six to eight                                                          Hospital of St. Raphael. He is an assistant
                                                 prevalence of hepatitis C among patients
drinks) in men, or 20 to 40 grams in                                                             professor of internal medicine, digestive dis-
                                                 transplanted for alcohol cirrhosis. In some
women over many years can result in alco-                                                        eases, at Yale.
                                                 instances, there may be a history of heavy
hol liver disease. How much one can              alcohol usage but not alcohol abuse or          Please note: The articles contained in this newslet-
imbibe is one of the most difficult ques-        alcoholism. These distinctions usually can      ter are provided for information only. They do not
tions a physician can answer. As window          be readily seen by members of the trans-        constitute medical advice and should not be relied
shopping is less injurious to the purse, cer-    plant team, but sometimes a liver biopsy is     upon as such. The American Liver Foundation (ALF)
                                                                                                 does not engage in the practice of medicine. Under
tainly the only recommended proximity to         needed to determine the underlying nature       no circumstances does ALF recommend particular
alcohol for the alcoholic is leche-vitrines.     of the cirrhosis. The primary goal of the       treatments for specific individuals, and in all cases,
Similarly, what is one person's infrequent       transplant center is to provide the avenue      recommends that you consult your physician
past-time is another person’s poison.            for transplantation and to facilitate the       beford pursuing any course of treatment. The ALF is
E.M. Jellinek, who was associate professor       pathway to sobriety. Success is not only a      a member of the National Health Council.
                                                              June 2008 Page 8
Speakers educate 300 on hep C in May                                                           Business Times honors
                                             who are health professionals who treat
                                                                                               CTALF’s executive director
Our Speaker’s Bureau reached more
                                             HCV patients, we are compiling a list             JoAnn Thompson, executive director of
than 300 people affected by hepatitis C
                                             of testing and treatment sites through-           the Connecticut Chapter of the
at seven venues around
                                             out the state where patients with or              American Liver
the state in May --
                                             without insurance can go for these                Foundation, was one of
Hepatitis Awareness
                                             services, which are vital to the success          20 women honored for
Month -- and it is exap-
                                             of clearing the hepatitis virus.                  her accomplishments and
nding both in numbers
                                             In June, we will train more than 40               professional services at
and in scope.
                                             students through the physicians’ assis-           the New Haven Business
We spoke at the
                                             tant program at Quinnipiac University             Times’ 14th Annual
Southeastern Council of        Phil Scarfo                                                                                    JoAnn Thompson
                                             to become part of our Speaker’s                   Twenty Noteworthy
Alcoholism and Drug
                                             Bureau. They are students of                      Women Awards breakfast April 3.
Dependence Inc.’s SCADD Lebanon
                                             Professor John McNab, who is an                   Thompson, who has more than 30 years
Pines Treatment Center for Men, the
                                             active member of our Associate                    of experience in the non-profits arena,
Rushford Center in Middletown, Day-
                                             Medical Advisory Committee and a PA               has progressed from a local volunteer to
Kimball Hospital’s Quinnebaug pro-
                                             at Hartford Hospital. We have                     a national board member to a fulltime
gram in Putnam and at the Hep C
                                             programs scheduled through                        executive director. She has made her
Support Group at Midstate Hospital in
                                             September, and continue to search for             mark in chapter development/market-
Meriden. We also addressed groups
                                             venues where we can present informa-              ing, board/volunteer management and
during Grand Rounds at Waterbury
                                             tion. Please let us know if you are               development, strategic planning, fiscal
Hospital, at Johnson Memorial Hospital
                                             interested in having a TCI program                management, human resources and
Social Services in Stafford, at St. Mary’s
                                             presented at your workplace.                      administration. Thompson has been
Hospital Behavioral Center in
                                             If you’d like to join the Treatment               pivotal in the ALF since the Connecticut
Waterbury and at Aids Project New
                                             Choices Initiative (TCI) Speaker’s                Chapter became a staffed office in 2000.
Haven in New Haven.
                                             Bureau, please contact me at at the               In her current capacity, she is responsi-
To date, we have presented more than
                                             ALF office, (203) 234-2022 or email               ble for all activities related to the
two dozen programs free of charge in a
                                    We plan              Chapter, including staff recruitment and
broad variety of venues.
                                             to hold a Volunteer Training Program              supervision, fundraising and program
Speakers provided valuable informa-
                                             in the early fall.                                services. She also has held leadership
tion about hepatitis C and the treat-
                                                                                               positions at the General Federation of
ment options. Our goal, however, is
                                                                                               Women’s Clubs, she has been a
not only to educate but to provide peo-
                                                                                               Girlstown board member; a PTA mem-
ple with the tools they need to be test-     Phil Scarfo is coordinator of the TCI
                                                                                               ber; and a member of the Children’s
ed and treated, if necessary. At the urg-    Speaker’s Bureau and administrative
                                                                                               Hospital Auxiliary.
ing of many of our volunteer speakers        assistant in the ALF CT Chapter office.

ALF awards support reasearch on a broad range of liver disease topics
Continued From Page 2                        Xiaosong Jiang, MD                                Research Fellowship
Mayo Clinic College of Medicine              University of California Davis Health System,     Johannes Kluwe, MD
Rochester, MN                                Sacramento, CA                                    Columbia University Medical Center,
TRPV4 as a Potential Target to Reduce the    The Role of Hepatic Stellate Cell Proliferation   New York, NY
Hyperproliferative Phenotype of              in Liver Fibrogenesis                             Role of NK-kB in the Crosstalk Between
Cholangiocytes in Polycystic Liver Disease                                                     Kupffer Cells and Hepatic Stellate Cells
                                             Hans Popper Memorial Postdoctoral Research
Roger L. Jenkins, MD Postdoctoral Research                                                     Alexander M. White, III Memorial Postdoctoral
Fellowship                                   Fellowship
                                             Xinqin Kang, PhD                                  Research Fellowship
Tina L. Sumpter, PhD                         University of Louisville, Louisville, KY          Ajay K. Jain, MD
University of Pittsburgh, Pittsburgh, PA     Hepatocyte Nuclear Factor 4 and Lipid             Baylor College of Medicine, Texas Children's
Molecular Crosstalk and the Regulation of    Export in Alcoholic Liver Disease                 Hospital, Houston, TX
Tolerance in Liver Dendritic Cells                                                             Role of Farnesoid X Receptor (FXR) and
Herman Lopata Memorial Hepatitis             Dean Thiel Memorial Postdoctoral Research         Fibroblast Growth Factor 19 (FGF19) In
Postdoctoral Research Fellowship             Fellowship                                        Parenteral Nutrition Associated Liver Disease
Nam-Joon Cho, PhD                            Benoit C. Callendret, D.V.M., PhD                 (PNALD)
Stanford University, Stanford, CA            The Research Institute at Nationwide
Hepatitis C Virus Replication in Optimized   Children's Hospital, Columbus, OH                 Liver Scholar Award
Hydrogel-based Hepatic Tissues               Immunity Against Hepatitis C Virus Upon           Costica Aloman, MD
                                             Superinfection                                    Mount Sinai Medical School, New York, NY
Congressman John Joseph Moakley                                                                Modulation of Liver Fibrosis by Dendritic
Postdoctoral Research Fellowship             Charles Trey, MD Memorial Postdoctoral            Cells
                                                   June 2008 Page 9
                  Clinical trials currently enrolling patients at    who are treatment-naive to                         Clinical trials currently enrolling patients
                  Yale University School of Medicine                 nucleoside/nucleotide analogues.                   at UConn Health Center.
                                                                     Primary investigator: Joseph K. Lim, MD.           Hepatitis C
                  Portal Hypertension Variceal                                                                            Trial: A Phase 2 Randomized, Open
                                                                     Contact: Hong Chau, M.P.H.,
                  Hemorrhage                                                                                            Label, Multicenter, Therapeutic Trial of
                                                                      (203) 785-3409
                     Trial: Vapreotide (Sanvar) as an Adjunct                                                           the Efficacy, Immunogenicity, and Safety
                                                                     Sponsor: Bristol-Myers Squibb
                  to Endoscopic Band Ligation for the                                                                   of GI-5005; an Inactivated Recombinant
                  Treatment of Acute Esophageal Variceal                                                                Saccharomyces cerevisiae Expressing a
                                                                        Trial: Entecavir plus Adefovir vs. Adefovir
                                                                                                                        Hepatitis C Virus NS3-Core Fusion
                  Bleeding in Patients with Cirrhotic Portal         vs. Entecavir for                                  Protein, Combined with Pegylated
                  Hypertension                                       Lamivudine-Resistant HBV                           Interferon plus Ribavirin Standard of Care
                  Who is eligible? Patients with upper gas-          Infection -- the DEFINE Study                      Therapy versus Standard of Care Alone,
                  trointestinal bleeding and known or                Who is eligible? Patients with chronic hepa-       and GI-5005 Salvage of Standard of Care
                  suspected liver cirrhosis.                         titis B infection (HBeAg + or -)                   Failures, in Patients with Genotype 1
                  Primary investigator: Joseph K. Lim, MD.                                                              Chronic Hep C Infection.
                                                                     who have developed resistance to lamivudine
                  Contact: Hong Chau, M.P.H.,                                                                           Summary: This will be a randomized,
                                                                     and are treatment-naive to other                   open label, multi-arm, multi-center, thera-
                   (203) 785-3409                                    nucloside/nucleotide analogues                     peutic trial comparing pegylated interfer-
                  Sponsor: Debiovision                               Primary investigator: Joseph K. Lim, MD.           on plus ribavirin (SOC), versus the sub-
                                                                     Contact: Hong Chau, M.P.H.,                        cutaneous administration of multiple
                  Chronic Hepatitis C Infection
                                                                      (203) 785-3409                                    doses of GI-5005 in combination with
                     Trial: GI-5005 Tarmogen
                                                                     Sponsor: Bristol-Myers Squibb                      pegylated interferon plus ribavirin in
                  Immunomodulatory Therapy plus PEG-IFN                                                                 patients with chronic genotype 1 hepatitis
                  plus Ribavirin for Non-Responders to PEG-             Trial: Entecavir vs. Adefovir for               C infection who are either treatment naïve
                  IFN plus Ribavirin                                 Decompensated HBV Cirrhosis                        or non-responders to a prior interferon
                  Who is eligible? Patients with genotype 1                                                             based regimen using pegylated or non-
                                                                     Who is eligible? Patients with chronic hepa-
                  hepatitis C who failed to achieve 2                                                                   pegylated interferon alpha with ribavirin.
                                                                     titis B-associated cirrhosis and
                  log drop within the 1st 12 weeks of stan-          evidence of hepatic decompensation.                Primary Investigator: George Wu, MD
                  dard PEG-IFN plus ribavirin therapy.               Primary investigator: Joseph K. Lim, MD.           Contact: Chidinma Byron, APRN (860)
                  Primary investigator: Joseph K. Lim, MD.           Contact: Hong Chau, M.P.H.,                        679-4260,
                  Contact: Hong Chau, M.P.H.,                         (203) 785-3409                                    Sponsor: GlobeImmune
                   (203) 785-3409                                    Sponsor: Bristol-Myers Squibb
                  Sponsor: Globeimmune                                                                                  Hepatitis B
                                                                                                                           Trial: Trial: A Comparative Study of
                                                                     Fatty Liver Disease
Clinical Trials

                     Trial: Consensus Interferon (Infergen)                                                             Entecavir vs Adefovir vs the Combination
                                                                         Trial: Rimonabant for the Treatment of
                                                                                                                        in Lamivudine-Refractory Chronic Hepatitis
                  plus Ribavirin for Partial Responders or           Non-Alcoholic Steatohepatitis in                   B Subjects: The DEFINE Study
                  Relapsers to PEG-IFN plus Ribavirin                Patients with Diabetes Mellitus Type 2             Summary: This is a three-arm, comparative,
                  Who is eligible? Patients with genotype 1          Who is eligible? Patients with biopsy-proven       randomized, open-label, multi-center study.
                  hepatitis C who achieved a 2 log                   NASH and diagnosis of DM2.                         Subjects will be randomized 1:1:1 to
                  drop but not an undetectable HCV RNA at            Primary investigator: Joseph K. Lim, MD.           receive entecavir plus adefovir combination
                  week 12 of standard PEG-IFN plus                   Contact: Hong Chau, M.P.H.,                        therapy, or entecavir monotherapy, or ade-
                  ribavirin.                                                                                            fovir monotherapy for 100 weeks, with the
                                                                      (203) 785-3409
                                                                                                                        primary endpoint at Week 48.
                  Primary investigator: Joseph K. Lim, MD.           Sponsor: Sanofi-Aventis                            Principal Investigator: George Wu, M.D.,
                  Contact: Hong Chau, M.P.H.,                           Trial: Rimonabant for the Treatmen to           Contact: Chidinma Byron, APRN, (860)
                   (203) 785-3409                                    Non-Alcoholic Steatohepatitis in Patients          679-4260
                  Sponsor: Valeant                                   Without Known Diabetes Mellitus Type 2             Sponsor: Bristol-Myers Squibb
                                                                     Who is eligible? Patients with biopsy-proven          Trial: A Randomized, Observational
                    Trial: Eltrombopag plus PEG-IFN plus                                                                Study of Entecavir to Assess Long-term
                                                                     NASH and no diagnosis of DM2.
                  Ribavirin for Treatment-Naive Hepatitis C                                                             OutcomesAssociated with
                                                                     Primary investigator: Joseph K. Lim, MD.
                  Infection                                                                                             Nucleoside/Nucleotide Monotherapy for
                                                                     Contact: Hong Chau, MPH, (203) 785-3409            Patients with Chronic HBV Infection: The
                  Who is eligible? Patients with hepatitis C
                                                                     Sponsor: Sanofi-Aventis                            REALM Study.
                  and thrombocytopenia (platelet
                                                                        Trial: Vasoconstrictors in the treatment of     Summary: This is a randomized, open-
                  count <70,000) precluding standard PEG-
                                                                     refractory ascites. Yale University and VA         label observational study in which
                  IFN plus ribavirin.                                                                                   patients will be randomized (1:1) to an
                                                                     Connecticut Healthcare System are actively
                  Primary investigator: Joseph K. Lim, MD.           recruiting                                         HBV treatment regimen comprised of
                  Contact: Hong Chau, M.P.H.,                        for a study in patients with cirrhosis who         nucleoside/tide monotherapy with either
                   (203) 785-3409                                    have ascites and require paracentesis. The         ETV or another standard of care HBV
                  Sponsor: Glaxo-Smith Kline                         aim of this study is to reduce the number of       nucleoside/tide analog.
                                                                     paracenteses required by using vasoconstric-       Primary Investigator: George Wu, MD
                  Chronic Hepatitis B Infection                      tors. The study medications will be available      Contact: Chidinma Byron, APRN (860)
                     Trial: Entecavir plus Tenofovir vs.             to paticipants at no cost. If you are interested   679-4260,
                  Entecavir Monotherapy for Treatment-               in this study and need further information,        Sponsor: Bristol-Myers Squibb
                                                                     Primary investigator: Guadalupe Garcia-Tsao,       Hepatitis B
                  Naive HBV Infection -- the BELOW Study
                                                                     M.D.                                                Trial: A multicenter, randomized, open-
                  Who is eligible? Patients with chronic hep-        Contacts: Dr Sakib Khalid or Carolyn
                  atitis B infection (HBeAg + or -)                  Paul at (203) 932-5711 ext 2206.                   Continued on Page 11

                                                                    June 2008 Page 10
Hot culinary gala slated for cool autumn night                                               Clinical Trials
                                                                                             Continued from Page 10
Flavors of CT Fairfield County 2008         grant for research on liver diseases and         label controlled study of the effect of treatment
will take place Tuesday Nov. 18th at        further education. The evening will              with once weekly Pegasys plus daily Copegus
the Holiday Inn of Stamford.                be hosted by Honorary Chef                       with or without comcomitant pioglitazone
Don’t miss your chance to mingle with       Chairmen Jason Milanese of the                   (Actos) on early viral kinetics in treatment-
Fairfield County’s premier chefs while      Saltwater Grille in Stamford and Jake            naive pateints with chronic hepatitis C (geno-
supporting a great cause. This show-        Koski of Dragonfly Lounge in                     type-1 HCV infection) and insulin resistance,
case of 15 of the area’s favorite restau-   Stamford, and Host Chairman Jason                Who is eligible? All patients 18 and older with
rants will be an evening talked about       Charbono of 700 Main Street,                     genotype-1chronic hepatitis C infection and
for months. The event will begin with       Stamford. Here’s a sneak peek at some            insultin resistance who have not received prior
a cocktail, wine and tequila reception      of the restaurants: Blue Lemon of                antiviral therapy with interferon or combination
featuring appetizers from each chef as      Westport, DaPeitro’s Restaurant &                therapy with interferon and ribavirin.
well as music and a tempting silent         Zest Café of Westport, g/r/a/n/d of              Sponsor: Roche
                                                                                             Primary Investigators: John Polio, MD, and
auction. Following the reception,           Stamford and Barcelona Wine and                  Martin Hoffman, DO.
WTNH-TV’s Matt Scott, emcee, will           Tapas Bar.                                       Contact: Sharon Dellinger, ARPN, (860) 522-
inform guests at which chef’s table          A limited number of tickets and the             1171.
they will be dining. Each chef will         following sponsorships are available.              Trial: An open-label, randomized, multicen-
prepare a five-course dinner comple-        Platinum Sponsor: $6,000                         ter, active-controlled, dose-ranging study to
mented with wine pairings for his or        Gourmet Sponsor: $3,000                          evaluate the safety and efficacy of albinterferon
her table of 10 to 12. The evening also     Individual Ticket: $200                          alfa‑2b (1500 µg, 1800 µg, 2100 µg and
will feature a live auction, including                                                       possibly 2400 µg) administered every 4
                                            Dress is creative black tie.                     weeks plus ribavirin in interferon alfa-naïve
enticing trips, jewelry, wine dinners       For tickets, sponsorships and informa-
                                                                                             patients with genotype 1 chronic hepatitis C
and much more. The Fund-A-Grant             tion, please contact the ALF at (203)
                                                                                             Primary Investigator: George Wu, MD
presentation will allow guests the          234-2022, or visit www.liverfounda-              Contact: Chidinma Byron, APRN (860) 679-
chance to make a donation and fund a                        4260 or 679-4964,

               In Memory of:                          Jacob Jaison                             Alison Cubbellotti
               Edward McCarthy                        Nancy Eisenstein                         Sharon Sztuma
               Debi & Bill Olivier                    Thomas J. Franklin
                                                                                               Dr. John Polio
               Bruce Barr                             James & Antoinette Shea
                                                                                               Thomas Alemany
               Celeste Cayer                          Gerta O'Connell
                                                                                               David Roncari Construction Services
                                                      Mr. & Mrs. Arthur Morin III & Family
               Ruth Palumbo Rahrig                                                             Charles Day
               Joan Watkins                           Harvey Dean                              Harry & Martha Fine
                                                      Maria Williams                           Amy Goodusky
               Isaac Elias                            Marilyn Dessecker                        Peter & Ellen Hankard
               Lucy Elias                             Nancy Urinas                             MaryAnn & James O'Neill
               Felicia Beebe                                                                   Joseph Preira

                                                      Norma Schaefer
               Barbara Weiand                                                                  Sara Preston
                                                      Bonnie Goldberg
                                                                                               David & Gilda Roncari & Family
               Esther M. Grosner                      Margaret Aikens                          Robin Rocari & John Seaha
               Jane D. Weiss Family Foundation        Cheryl Ann Impellizzeri                  Patricia & Harley Root
               Joe & Anne Gruce                                                                Marc & Laura Shafer
                                                      Rob Morrison
               Scott Fairchild                                                                 Cheryl & Robert Steciak
                                                      Luellen & Thomas Lockwood
               TheoAnn Cone                                                                    Lea Stroman
               Carol Correnti                         Robert Piskura                           James & Nancy Thompson
               Carole & Walter Swanson                CT Dept Transportation Employees         Deborah Roncari
               Margaret Geddes

               Gladys Wrinn Reich                                                                                     To give a gift of
                                                      In Honor of:
               Rebecca Reich Sammito                                                                                  remembrance,
                                                                                                                      call (203) 234-2022,
               Frank Gazsi                            Ann & Art Yost
                                                      Karla Perlman & Jack O'Brien
                                                                                                                      or write to the ALF,
               AlstomPower, Inc.
                                                                                                                      127 Washington Ave.
               Marc Reamer                            Anthony G. Cervoni                                              North Haven, CT 06473.
               Patricia & Robert Sisk                 Gail Gionfriddo

                                                        June 2008 Page 11
                LIFE is the official newsletter of the American Liver Foundation

               Our Mission             The American Liver Foundation is the nation’s leading nonprofit
               organization promoting liver health and disease prevention. We provide research, education,
               and advocacy for those affected by liver-related diseases, including hepatitis.
Board of Directors                      Medical Advisory Committee              Karan Emerick, MD                           Michael Nathanson, MD
                                        Pramod Mistry, MD, Chairman             Connecticut Children’s Medical Center       Yale-New Haven Hospital
Yolanda Belmont, LCSW, President
John Polio, MD, Vice President          Yale University School of Medicine      Sukru Emre, MD                              John Polio, MD
                                        David Hull, MD, Vice Chairman           Yale University School of Medicine          Hartford Hospital and St. Francis Hospital
Debera Palmeri, RN-CCTC, Secretary
                                        Hartford Hospital                       Joseph Fiorito, MD                          David Sack, MD
Robert Balchunas, CPA, Treasurer
                                        Kim Alleman, APRN, Associate            Danbury Hospital                            Midstate Medical Center
Directors                               Chairman, Hartford Hospital             Gerald Franklin, MD                         Michael Schilsky, MD
Kim Alleman, APRN                                                               Danbury Hospital                            Yale University School of Medicine
                                        George G. Abdelsayed, MD, FACP,
Agnieszka Buller                        FACG, Bridgeport Hospital               Guadalupe Garcia-Tsao, MD                   Harold Schwartz, MD
Susan Griffin                           Andrew Bedford                          Yale University School of Medicine and VA   Griffin Hospital
David Hull, MD                          Bridgeport Hospital                     Healthcare System                           Mario Strazzabosco, MD, PhD
Rodney LeBlanc                          James Boyer, MD                                                                     Yale University School of Medicine
                                                                                Joel Garsten, MD
Andrea Lombard, RN, BSN,MPH             Yale University School of Medicine      Waterbury Hospital                          You Sung Sang, MD
Juan Carlos Lopez-Talavera, MD,PhD      Myron Brand, MD                         Martin Hoffman, MD                          Norwich Gastrointestinal Associates and
Catherine Petraiuolo                    Hospital of St. Raphael and Yale-New    St. Francis Hospital                        William W. Backus Hospital
Andre Sofair, MD                        Haven Hospital                                                                      Tamara Taddei, MD
                                                                                Jonathan Israel, MD                         Yale-New Haven Hospital
Executive Director                      Matthew Brown, MD                       Hartford Hospital
                                        Hartford Hospital                                                                   Renuka Umashanker, MD
JoAnn Thompson                          Cary Caldwell, MD                       Suzanne Lagarde, MD                         Hospital of St. Raphael
                                        Hospital of St. Raphael and Yale-New    Hospital of St. Raphael and Yale-New        Krystn Wagner, MD
Legal Advisor                                                                   Haven Hospital
                                        Haven Hospital                                                                      Yale University School of Medicine and
Stuart A. Margolis                                                              Robert Leventhal, MD                        Nathan Smith Clinic
                                        Dean Chang, MD
Honorary Board Members                  Hospital of St. Raphael
                                                                                Waterbury Hospital, St. Mary’s Hospital     George Wu, MD
Bonnie Goldberg                                                                 and Yale-New Haven Hospital                 UConn Health Center
                                        James Ciarcia, MD                       Joseph K. Lim, MD
Barry J.Vine                            Yale-New Haven Hospital
                                                                                Yale University School of Medicine
Joyce Willig                            David Cronin, II, MD
                                        Yale-New Haven Hospital

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                                                                                                                                               New Haven, CT
                                           Connecticut Chapter
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                                          North Haven, CT 06437

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