Stephen H. Caldwell, MD
Professor of Medicine
Division Historian
The Division of Gastroenterology and Hepatology at UVA, now headed by Dr James Scheiman well known for his seminal work in preventing post-ERCP pancreatitis, has a long history of significant academic contributions to these fields of study and to the training of Specialists/Consultants in this area who have gone on to successful work in both Academic and Private Practices. The Division is one of few in the country that can boast of having a Nobel Laureate among its alumni. The Fellowship Program, now directed by Neeral Shah, began in the early 1980s and has since trained 240 Fellows who have provided their skills and knowledge throughout all regions of the US in a variety of settings. The arrival of Richard McCallum and Ravi Mittal in the 1980’s brought with it the development of an advanced program in gut motility disorders. McCallum also recruited a little known, barely out of training, clinical investigator – Dr Barry Marshall who along with Pathologist Robin Warren had identified a new gastric infection. With key support from David Peura and Dick Guerrant, Marshall completed seminal studies at UVA linking Helicobacter pylori to peptic ulcer disease and gastric cancer. Marshall and Warren went on to win the Nobel Prize for this work in 2005.
Dr Marshall also trained some of our current Faculty including Stephen Caldwell who after Hepatology training under Eugene and Leon Schiff at Miami was recruited back to UVA in 1992 as co-Medical Director of Liver Transplantation. The Liver Transplant program, founded by Timothy Pruett in the 1980’s was already thriving under Pruett and William Stevenson and went on under Pruett’s direction to contribute pioneering work in HBIG passive immunization for preventing recurrent hepatitis B infection in the era prior to availability of anti-HBV therapeutics in the 1990s. The Hepatology group provided key support in these efforts and under Caldwell’s direction and later with Dr Curt Argo’s work also contributed seminal work in NASH with early descriptions of the relationship to cryptogenic cirrhosis, mitochondrial dysfunction, familial and ethnic variation, the natural history of NASH by serial biopsy and treatment with early thiazolidinediones. The association of this disorder with systemic metabolic syndrome eventually led Dr Zach Henry to help found one of the first multidisciplinary clinics addressing fatty liver and associated systemic metabolic disorders. The Hepatology group went on to help redefine many aspects of liver-related Coagulation Disorders under the direction of Caldwell, Patrick Northup, Neeral Shah and Nicolas Intagliata who continues with translational research on this subject and co-organization of an international biennial meeting on this topic that began in 2005. The group also worked to advance management of gastric varices with endoscopic cyanoacrylate and, through collaboration with Interventional Radiology, the selective application of endovascular (BRTO) approached to this problem. This collaborative work continues now largely under the direction of Dr Zach Henry.
Meanwhile, the Liver Transplant Program at UVA has continued to thrive almost 30 years since its founding and now under the Surgical Direction of Shawn Pelletier and Jose Oberholtzer and the Medical Directorship of Dr Patrick Northup with an active Transplant Hepatology Fellowship Program directed by Dr Curt Argo who also serves in a critical role as Medical Director of a growing Live Donor Liver Transplant program. The program has seen steady annual growth through its efforts at providing optimal and timely care to patients with advanced liver disease.
The GI Hepatobiliary program (ERCP) at UVA was started by Dan Pambianco working under David Stone in the mid-1980’s and later directed for years by Paul Yeaton and subsequently by Andrew Wang who currently leads a very dynamic program with colleagues Daniel Strand and Dushant Uppal with a very successful and competitive Advanced Biliary Fellowship program. UVA has also established a highly successful and renowned program in Endoscopic Ultrasound (EUS) which started under the direction of Vanessa Shami since the early 2000’s and more recently under both Dr Shami and Dr Bryan Sauer. Both are consistent contributors to advancement of the field especially in major teaching symposia by the ASGE and AGA. The IBD group was founded many years ago by the late James Roach and grew under the leadership of Fabio Cominelli during his tenure as Division Chief. It was subsequently led by Brian Behm who established UVA’s presence in many clinical trials of newer treatments of IBD and is presently led by Ann Tusky with aims to further grow this important aspect of the clinical practice. Advanced Endoscopy especially involving complex polypectomy and balloon enteroscopy has evolved over the many years of the program and is presently led by Andy Copland who serves as a major resource for Division members and outside referring providers for the most challenging polypectomies.
Other milestones in the Division history include the establishment around 1990 of a dedicated Nutrition Service largely dedicated to short gut syndrome and led for almost 30 years by Carol Parish and the establishment in 2011 of a dedicated hepatitis C treatment team which is now run through a combined Pharmacology and GI/Hepatology team led by Colleen Green, Virginia Kelly and Kiristy Coles who provide tremendous expertise in HCV therapy and procurement of appropriate therapy. Their work has increasingly interfaced with Transplantation services in the use of HCV positive donors as a response to organ shortage and availability of highly effective anti-HCV therapy. The addition of Ann Hays and Jim Mann in 2015 provided major strengths to the program. Dr Hays developed fecal transplant as a treatment of refractory C diff infection in work that is ongoing in collaboration with the Division of Infectious Disease and Dr Mann both augmented the Hepatobiliary team and supported the further advancement of the Motility team now under Dr Jeanetta Frye.
The Gastroenterology and Hepatology Division of UVA takes great pride in its resiliency and long and deep history of past and ongoing major contributions to both the scientific and clinical fields combining the major aims of Service, Education and Discovery. Past Division Chiefs include James Respess, Richard McCallum, David Peura, Fabio Cominelli, Carl Berg, Steven Cohn and Cindy Yoshida. The Division, now led by Dr James Scheiman, has just recently expanded both Luminal and Hepatology faculty with anticipation of further growth in all of the missions of the Division including Service, Education and Discovery. With this very strong past and ongoing present, we look forward to the future.
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Tags: DOM, Education, GI, July Medicine Matters, medicine matters