Health 3.0: A Discussion about Medicine at the Cutting Edge with the Mayo Clinic's Dr. Nicholas LaRu

Health 3.0: A Discussion about Medicine at the Cutting Edge with the Mayo Clinic's Dr. Nicholas LaRu

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A conversation with Professor of Medicine at Mayo Medical School, and Medical Director of the Center for Innovation at Mayo Clinic.

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Nicholas F. LaRusso:

Nicholas F. LaRusso, M.D., Charles H. Weinman Endowed Professor of Medicine, is Director of the Center for Innovation at Mayo and a Distinguished Investigator of the Mayo Foundation.

Prior to becoming Center Director in 2008, he was Vice Chair for Research of the Department of Medicine (DOM), Chair of the Division of Gastroenterology and Hepatology, and Chair of the DOM at Mayo Clinic. Before assuming a faculty position at Mayo in 1977, he was a guest investigator at the Rockefeller University in the laboratory of the Noble laureate, Christian de Duve. A member of the American Association of Clinical Investigation and the Association of American Physicians, he is the former editor of GASTROENTEROLOGY and past president of the American Association for the Study of Liver Diseases (AASLD). Among other honors, he is a recipient of a MERIT Award and the Principle Investigator on two R01s from the NIH; he also received Distinguished Achievement Awards from both the American Gastroenterological Association (AGA) and the AASLD, and the Distinguished Mentor Award of the AGA. He is currently President of the AGA.

He received his undergraduate degree (magna cum laude) from Boston College, his M.D. degree from New York Medical College, and his training in internal medicine and gastroenterology at Mayo, the latter as an NIH fellow in the laboratory of Alan Hofmann.

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TRANSCRIPT:

Question: What initiatives are you working on at Mayo?

Nicholas LaRusso: We now have active pilot projects testing the ability to provide what we call eConsoles, or virtual consoles, electronically to providers all over the country, primary care providers. We believe that the initial effort should not be directly to patients but the patients to their primary care provider because we think that patients are ultimately going to need a continuous relationship with a team of providers in their own community. That’s a second initiative that we have. It’s something called the Advanced Medical Home where we’re organizing teams of providers to maintain a continuous relationship with patients within their community.

The third initiative, that gets to the genetic profiling, is we’re trying to understand through designer-centered research. This is available commercially. There are three companies out there that will provide you with a genetic analysis if you provide them with the biological specimen, whether it’s a blood sample or a spit sample or a hair sample. We’re trying to find out what do patients expect when they do this, and when they get the information that says they have, based on your genetic profile, 40% increased chance of getting type II diabetes or threefold increase in the chance of getting Alzheimer’s disease. How do they understand that? How does that affect the way they think about their health? What do they do with that information? What do the primary care providers that they may go to with that information, how do they understand it? How does this affect their ability to modify their lifestyle? And so, that will be a third concrete project that we’re engaged in.

Question: What is the future of organ transplantation?

Nicholas LaRusso: One of the great things about the liver is that it regenerates. So, if you cut half of someone’s liver, it grows back. That’s why we can now not only use cadaver livers, but we can use portions of living donors. It’s entirely possible, and there’s work being done in this area, that in the future a liver transplant will be no more than an injection of a number of cells that will implant somewhere in the body and will grow and form an entire new liver. This is the whole area of stem cell transplantation

Then I think the last area, and this is a fairly controversial area, but I think has great potential, and the background here is, that as you maybe aware, there are many people particularly with liver disease, many more people that need livers than we currently have livers for.

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