2024-2025 Review

patient care

Liver Transplant Program Reaches Major Milestones

The Liver Transplant Program achieved major milestones. In 2024, the program broke the state of Michigan record for the most liver transplants performed by an institution in a single year. The program closed out the year with 131 liver transplants completed across adult and pediatric patients. In addition, 2025 marked the program's 3,000th liver transplant - a record-setting accomplishment for the most liver transplants performed by a single center in Michigan. This achievement came under the leadership of our new program director, Alexandra Shingina, MD, MSc, whose guidance is helping shape the next era of excellence in transplant care. To further expand access, we also launched a liver transplant outreach clinic in Grand Rapids in partnership with Trinity Health. This new location allows patients in western Michigan to complete pre-transplant evaluations and testing closer to home, reducing travel burdens and supporting more seamless, coordinated care. “Expanding our ability to evaluate patients on the west side of the state closer to their homes is a critical step in increasing access to transplant to more residents of Michigan,” said Christopher Sonnenday, MD. “This expansion furthers our mission to make the transplant process smoother for all of our patients while they navigate the complexity of transplant care.”

FDA Approves Gastrointestinal Device Developed by Drs. Shah and Chey

The U.S. Food and Drug Administration approved the Rectal Expulsion Device (RED), developed by Eric Shah, MD, and William Chey, MD, to enhance the diagnosis and treatment of chronic constipation. Featuring a simple tube-and-balloon design, RED allows clinicians to identify pelvic floor dysfunction during an office visit, helping reduce unnecessary referrals and ineffective treatments. The device also enables earlier diagnosis and more accurate prediction of treatment outcomes compared with traditional approaches.

Alcohol-Related Liver Disease Clinic

Under the leadership of Ponni Perumalswami, MD, the Alcohol-Associated Liver Disease (ALD) Clinic was restructured to improve access, streamline care, and emphasize holistic addiction treatment. It is the first ALD clinic in the United States to implement the Behavioral Health Collaborative Care model, a cost-effective, evidence-based framework for comprehensive behavioral health delivery in which an interdisciplinary care team collaborates through a shared care plan to systematically address the needs of patients with mild to moderate behavioral health disorders.

New Guideline for Helicobacter Pylori

William D. Chey, MD, was the corresponding author on new clinical guidelines published by the American Journal of Gastroenterology for the treatment of Helicobacter pylori (H. pylori). The updated guideline replaces the long-standing recommendation of proton pump inhibitor–clarithromycin triple therapy. For treatment-naïve patients, bismuth quadruple therapy—typically a PPI, tetracycline, bismuth, and a nitroimidazole for 14 days—is now the preferred first-line approach. “We were already encouraging providers to move away from PPI triple therapy in 2017 due to rising clarithromycin resistance in U.S. H. pylori strains,” said Dr. Chey.

Advancing Health Equity in GI

In November 2025, Kira Newman, MD, PhD, was honored with the 2025 Healio Disruptive Innovator in Health Equity Award. Her work addresses social determinants of health in GI care, with a focus on sexual and gender minority (LGBTQIA+) patients with digestive diseases, as well as microbiome research related to infection risks in inflammatory bowel disease.

research

In 2024, we earned more than $23 million in research funding—our strongest year yet—driven by the remarkable expertise and innovation of our faculty. In 2025, we earned more than $17 million in research funding.

Richard Kwon, MD, MS, co-authored a study published in Nature Microsystems & Nanoengineering looking at a new sensor for bile duct stents that may soon allow doctors to detect and address blockages early, helping patients stay healthier. “This novel stent sensor provides the opportunity to detect impending biliary stent obstructions without waiting for clinical symptoms, blood tests or imaging tests, all of which delay intervention,” said Dr. Kwon. Developed with advanced magnetoelastic technology, the sensor has shown strong performance in preclinical testing. Future plans include adapting it for metal stents, miniaturizing multiple sensors along a stent for localized detection, and lowering the cost of the readout system. The technology could eventually expand to other types of stents in the body.

Targeted Blood-Test-Guided Diets Show Improved Outcomes for IBS

Prashant Singh, MBBS, and William Chey, MD, published a study in Gastroenterology demonstrating that an IBS-specific IgG blood test can guide elimination diets to effectively reduce abdominal pain. In a multicenter, randomized trial of 238 participants with irritable bowel syndrome, 59.6% of patients following the IgG-guided diet met the FDA standard for clinically meaningful pain reduction, compared with 42.2% on a sham diet. “This test is scientifically supported and can help guide individualized diets for IBS,” said Dr. Singh. Unlike broader approaches such as low FODMAP, the IgG-based strategy targets only the foods that trigger symptoms for each patient, making it easier to follow while avoiding unnecessary dietary restrictions.

New Prognostic Tool for Drug-Induced Liver Injury (DILI)

Robert J. Fontana, MD, and Alisa Likhitsup, MD, published a new scoring system — the DILI‑Inpt prognostic score — designed to predict which hospitalized patients with severe idiosyncratic drug-induced liver injury will likely need a liver transplant, versus those who might recover with supportive care. This tool outperformed existing systems such as MELD and King’s College Criteria in a retrospective study of 305 adults.

Lactulose and Tai Chi Show Promise Preventing Falls for Cirrhosis Patients

Elliot Tapper, MD, presented results of the LiveSMART Trial as a late-breaking abstract at The Liver Meeting 2025. The results: lactulose treatment followed by tai chi significantly reduced both injurious and non-injurious falls in people with cirrhosis in a 24-week randomized trial, suggesting these accessible interventions could improve safety and quality of life for patients with advanced liver disease.

education

New Fellowship Track

We recently launched the first dedicated non-transplant hepatology fellowship — a major milestone in our training mission. Two fellows have entered the inaugural class, marking the beginning of what we expect to become a robust, long-term educational pathway. By establishing this non-transplant track, we are expanding access to specialized hepatology training focused on acute and chronic liver diseases outside of transplant care. Fellows in this track will benefit from our existing infrastructure — including long-standing clinics for fatty liver disease, viral hepatitis, cirrhosis, liver tumors, and other liver disorders — and will be mentored by faculty recognized nationally for their expertise in liver disease research and guideline development.

Inaugural GI Fellows Teaching Forum

In September, more than 40 doctors from seven medical systems attended the Inaugural Michigan GI Fellows Teaching Forum, a groundbreaking event designed to foster collaboration, share best practices, and build connections within the statewide community of GI fellows and program directors. Hosted by Robert Fontana, MD, the forum aimed to provide a unique opportunity for fellows from Michigan and Ohio to come together, learn from one another, and strengthen professional ties in a growing and evolving field. The event featured a series of didactic talks from leading experts, including William Chey, MD, who discussed the role of diet in the management of irritable bowel syndrome (IBS), Ponni Perumalswami, MD, who presented on the management of acute alcoholic hepatitis, Jeffrey Berinstein, MD, MS, who shared insights on severe acute ulcerative colitis, and Richard S. Kwon, MD, who focused on endoscopic approaches to colorectal neoplasia. These talks were complemented by the fellows' own contributions: one fellow from each participating program presented a clinical case and led discussions, fostering peer-to-peer learning and engagement. One of the highlights of the forum was a live endoscopic gastric sleeve procedure for obesity, performed by Allison Schulman, MD, MPH. This procedure, which many participants had never seen before, gave fellows a rare and invaluable opportunity to witness cutting-edge techniques in action. In addition to the educational content, the forum also provided an important platform for trainees and faculty to engage with GI device manufacturers. This allowed participants to learn about the rapidly growing range of interventions and products available to GI doctors, enhancing their ability to provide the most advanced care for their patients. The forum was met with enthusiasm and positive feedback from all attendees, emphasizing the importance of creating a space for fellows and faculty to interact, share knowledge, and develop professional relationships. Based on the success of this inaugural meeting, plans are already in place to hold the Michigan GI Fellows Teaching Forum every September moving forward. The event will continue to expand, with the goal of involving even more programs and participants from across the region.

Annual Liver Disease Wrap-Up

We held our 27th Liver Disease Wrap-Up—an annual, in-person continuing medical education course that brings together community healthcare providers who care for patients with liver disease. Directed by Robert Fontana, MD, and Anna Lok, MD, the event featured presentations from many of our hepatology experts, offering the latest advances in diagnosis, management, and treatment of liver diseases and their complications. The course continues to strengthen partnerships with community clinicians and support high-quality, evidence-based care across the region.

FOOD: The Main Course to Digestive Health

FOOD: The Main Course to Digestive Health, a national conference directed by William Chey, MD, held its 9th annual meeting in 2025. The conference provides continuing education for dietitians and other health professionals focused on the nutritional care of patients with gastrointestinal (GI) diseases. The program is designed to advance clinical knowledge in GI nutrition and the dietary management of digestive disorders for registered dietitians (RDs/RDNs) and related health professionals. In 2025, the conference attracted 300 learners from across the United States, reflecting its sustained national impact in GI nutrition education.