MOTION

Lead Institution: Medical University Vienna

Head: Univ.-Prof. Priv.-Doz. Dr.med.univ. Thomas Reiberger

Mentor: Univ.-Prof. Dr.med.univ. Michael Trauner

Deputy Head: Ap.Prof. Priv.-Doz. Dr.med.univ. et scient.med. Mattias Mandorfer

Project Manager: Olivia Gugler

Kontakt: Olivia Gugler byvivn.thtyre@zrqhavjvra.np.ng, Alexandra Weisgram nyrknaqen.jrvftenz@zrqhavjvra.np.ng

The clinical research group MOTION is working to improve the diagnosis and treatment of liver diseases. One major focus is on understanding portal hypertension (PH)—elevated blood pressure in the blood vessels supplying the liver. PH is the main cause of severe or even life-threatening complications in people with liver disease.

Since its start in October 2023, the research group has established three clinical studies and numerous additional projects on portal hypertension. All three clinical trials have been approved by the European Medicines Agency (EMA), and patient recruitment is ongoing in all projects—providing affected individuals with access to promising new treatment options. Each study is specifically targeted at a particular group of patients with PH:

• TECA study: Patients with advanced liver disease who have not yet developed symptoms
• NOPE study:Patients whose disease has already led to complications
• EXPOSURE study:Patients with a rare form of liver disease that primarily affects the liver’s blood vessels

Thanks to targeted funding, an efficient research infrastructure has been established, and valuable blood and tissue samples have been collected for scientific analyses. Initial results show that in patients with advanced liver disease, the renin–angiotensin system—a hormone system that primarily regulates blood pressure in healthy individuals—plays an important role. In patients with more advanced disease and complications, researchers found evidence of a pronounced inflammatory response in the body. These two patient groups were included in the ongoing Vienna Cirrhosis Study (VICIS), which now comprises more than 600 participants.

In addition, over 40 patients with rare vascular liver diseases have been enrolled in the VALID study, and their samples are currently being analyzed.

Several team members have been trained in the technique of non-invasive hepatic venous pressure gradient (HVPG) measurement, the most accurate method for assessing blood pressure in the liver. This HVPG technique represents the central outcome measure in the TECA and NOPE studies.

Based on data from VICIS and VALID, new methods have been developed to diagnose severe liver disease and portal hypertension without invasive procedures. One promising approach is the measurement of spleen stiffness, which improves existing non-invasive tests. These results have been published in leading scientific journals.

The team has also begun investigating blood coagulation in patients with portal hypertension. The first results are currently being prepared for publication. In addition, numerous CT scans of patients with liver disease have been analysed using modern image-processing techniques and artificial intelligence. This may soon allow the severity of portal hypertension to be estimated from routine imaging—potentially avoiding invasive tests in the future.

In parallel, several laboratory-based research projects have been launched to examine how blood vessel cells change in portal hypertension. Initial results were presented at a medical conference in September 2024, and final analyses are now being prepared for publication.