Marlyn Mayo, M.D. Answers Questions On: Liver Disease and Patient Care

Pregnant women walk into the door with their own preconceived notions and fears of how their disease should be handled, particularly around medications. Many women do not want to take any chances that a medication may hurt the baby, even if the chances are very small. I present the data for the medication, but also take into account the patients’ fears.

I love them all. So many of them are just like me or my mom or my sister or my grandmother.

There was a young nurse with cirrhosis and vertices who was having difficulty getting pregnant. She was told she should not get pregnant, but she had never had children and very much wanted to have children. Working together with fertility specialists, we were very cautious, took one step at a time, and she became pregnant and had a baby. Her baby was born prematurely, but now is almost a year old.

It’s a very exciting time to be working in liver diseases. For the first time, we are trying new therapies with a completely different approach. For the past 50 years, therapies have tried to suppress the immune system or make bile gentler. Now we are discovering potential new therapies that target the main inflammatory pathways specifically. Another category of drugs export bile out of the liver and are now in Phase III trials. Also, new intriguing trials use anti-retroviral medication used in HIV to target liver viruses in patients with primary biliary cirrhosis (PBC). So, there are three very different mechanisms of actions being studied, and it’s an exciting time to see results.