Relying on one of the largest collections of liver tissue samples ever acquired by a single organization, Geisinger Health System researchers have embarked on a massive study// of one of the fastest growing liver problems.

Nonalcoholic fatty liver disease starts with the accumulation of fat on the liver, which leads to inflammation and scarring. It can progress to the point of permanent liver damage and lead to the potentially fatal cirrhosis. If the damage becomes too great, a liver transplant may be needed. Linked to America's increasing obesity problem, doctors have predicted a steep increase in the coming years.

The disease is asymptomatic in its early stages and many people don't know they have it initially. Geisinger Health System is leveraging several key system resources in an effort to develop a simple blood test to diagnose the disease. Early detection would likely help patients better manage the disease and could even save lives. Yet a major obstacle needs to be cleared first.

Right now, the only way to definitely diagnose the disease is through a liver biopsy, where a needle is inserted into the skin and liver tissue is collected. However, biopsies can pose health risks because of the potential for bleeding from the liver or for infection.

The goal is to develop a noninvasive blood test for the disease and then bring it to market so other physicians can use it, said Geisinger staff scientist Glenn S. Gerhard, MD.

To that end, Geisinger is uniquely positioned to develop such a test because of the array of resources the system has at its disposal.

Geisinger has collected more than 600 liver tissue and blood samples donated from patients who have undergone bariatric weight loss surgery. That work has been made possible through collaboration among Geisinger researchers, clinicians and surgeons.

Thanks to the very high participation rate of patients, the size of Geisinger's liver tissue and
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