Every year in the United States there are 18,000 people in need of a liver transplant.

About 5,000 receive transplants. Another 3,000 die waiting.

"That's quite a disparity," said David Gerber, assistant professor of surgery. "While there's an excellent success rate for patients who have transplants, we need to find better, less-invasive methods for treating liver disease."

So as Gerber continues to perform transplants, he and fellow researchers are also working behind the scenes, determined to find a cure for liver disease.

Right now they're focusing on stem cells—essentially cells without an assigned function. There are two types of stem cells: embryonic stem cells, which, as the name suggests, come from embryos; and adult stem cells, which are found in human tissues or organs. Embryonic stem cells tend to be less specific—they can become any sort of body cell including muscle, liver or nerve. Adult stem cells' primary role is to maintain and repair the tissue or organ in which they live. Gerber's research involves adult stem cells.

The plan is to use adult liver stem cells to create an artificial liver of sorts. Ideally, he'll create a liver scaffolding, or skeleton, and insert a liver chip—much like a computer chip but with adult stem cells—which will then grow and potentially create a new liver. Experiments on mouse models are going well.

The next step is to take the experiments to the human level. But that requires a whole new set of rules—human consent, FDA approval—and money. "At first we thought our biggest challenge was going to be developing the ideas, but really it's taking our ideas and moving forward—translating them into clinical applications— because it's so expensive," Gerber said.

Money for such research doesn't typically come from university or federally-funded grants, but rather from private investors or companies who see the technology's commercial potential.

Sometimes, the money comes from unexpected sources—from people like Jim Hardison whose father and grandfather died from liver cancer. Hardison, a 1979 Carolina graduate who donated $50,000 toward Gerber's research, said, "I already knew I wanted to give to Carolina, but I just wasn't sure where. With my father's illness I decided to support something related to research in liver disease."

H. Shelton Earp, director of the UNC Lineberger Comprehensive Cancer Center, suggested Hardison talk to Gerber. "It was a great partnership to meet somebody who pertained to my dad's illness," Hardison said. "My gift is a small way to help and to honor my father. Gerber's doing work that could one day help people like my dad and granddad."

"Jim's gift will go a long way toward helping us take our technology from the lab into the clinic," Gerber said. "I can't tell you how much his gift means."

Once there's enough support, Gerber and his team will begin studying stem cells from human livers and applying their liver chip technology. Ultimately, Gerber would like to be able to implant a liver chip into a patient with a scarred or diseased liver, giving them function without replacing the whole liver. "Instead of treating the disease, we'd be curing the disease," Gerber said.

The idea is that once researchers figure out how to harvest human adult stem cells you could potentially grow a new liver from your own organs. Besides liver disease, adult stem cells could also be used to cure diabetes. " By the end of the decade, there will be more than 30 million people with diabetes in the United States. With this technology, it may be possible to educate stem cells to produce insulin," Gerber said.

Another application would be to use adult stem cells to create mini-organs so that doctors could test how a patient would react to a particular drug.

Many researchers refer to stem cells as cells with potential—potential to become any type of cell or potential to help us revolutionize health care by leading to cures for disease.

"It (Gerber's research) makes so much sense," Hardison said.

Catherine House

Gerber and his business partner Jian Wang, research assistant professor of surgery, founded DAJI Biosciences—a start-up company based on their research. Hardison is a member of the Carolina First national campaign committee. He, his wife, Kathleen, and their two children live in Winston-Salem.