Director:
Daniel Shouval, M.D.
Professor of Medicine

Staff:
Yaron Ilan, Associate Professor of Medicine
Rifaat Safadi, M.D., Lecturer in Medicine
Oren Shibolet, M.D., Instructor in Medicine
Yaffa Ashur, M.D., Associate
Yizhar Levi, M.D., Associate
Eitan Galun, M.D., Associate Professor of Medicine (Gene Therapy Institute)
Ruth Adler, Ph.D.
Jonathan Axelrod, Ph.D.
Mali Kzin-El Gilad, Ph.D.

Visiting Clinical Fellows:
Alice Herskovic, M.D.

Clinical Activity
The Liver Unit serves as a main referral clinic for patients with acute and chronic liver disease in Israel. Ambulatory patients are admitted on a daily basis (walk-in clinic) through referral of their physicians or through self-referral. Emergency cases are admitted through the emergency room or directly to the departments of the division of medicine or the medical intensive care unit. Around 5000 visits are recorded annually in the outpatient clinic. One of the major activities of the Liver Unit is evaluation, selection and follow-up of patients before and after liver transplantation. Currently over 200 patients have been referred by the Liver Unit for liver transplantation. About 150 of these patients are under routine follow-up in the outpatient clinic, of whom over 100 patients were transplanted at the Hadassah Medical Center.

Research Activities:
The main research projects of the Liver Unit focus on prevention and treatment of viral hepatitis, primary liver tumors and liver transplantation. Professor Shouval's group is currently involved in development of a new vaccine against hepatitis B. This vaccine has been instrumental in the study for adoptive transfer of immunity in patients undergoing stem cell or bone marrow transplantation. Dr. Shouval is leading a collaborative pilot study to evaluate the role of hepatitis A immunization post-exposure (instead of immune serum globulin). The Liver Unit is also involved in testing of a number of new anti-viral drugs against hepatitis B and C virus infections, as well as against primary liver cancer.

Awards and Distinctions
In the past 20 years 4 members of the Liver Unit received the prestigious American Liver Foundation Award for the best research work presented at the Annual Meeting of the American Association for the Study of the Liver. Several studies performed during the past decade were selected by a number of organizations as outstanding research work and published in the Year Book of Medicine and in the Harvard Letter report.

Research Activities:

1. Prevention and treatment of hepatitis B virus infection and its complications.
2. Screening and immunization of neonates born to hepatitis B virus carrier mothers.
3. Clinical trials with an inactivated hepatitis A vaccine.
4. Adoptive transfer of immunity to hepatitis B virus infections.
5. Clinical trials: Treatment of chronic HBV infection with new antiviral agents or induction of antigen specific oral tolerance.
6. Immunemodulation via induction of oral tolerance in the presence of pre-existing immunity.
7. Induction of oral tolerance via feeding of bystander antigens as a treatment for experimental colitis.
8. The effect of anti-tumor and anti-HBsAg tolerance induction on suppression of experimental hepatocellular carcinoma in mice via adoptive transfer of immunity.
9. Chemoembolization for hepatocellular carcinoma.
10. Development of new hepatitis B immune globulins for prevention of hepatitis B virus re-infection after liver transplantation.
11. Development of human monoclonal antibodies to hepatitis B and C virus infection (in collaboration with Dr. E. Galun (P.I.), The Weizman Institute and XTL Biopharmaceuticals).
12. Vertical transmission of hepatitis C virus.
13. Clinical trials: Treatment of chronic HBV infection via induction of antigen specific oral tolerance.
14. The role of liver associated lymphocytes expressing NK1.1 in immune modulation.