Since October 1, 2023, he has been leading the Clinical Research Group (KFG) MOTION of the Ludwig Boltzmann Society. In this interview, he shares the goals of his team, why new treatment approaches for portal hypertension are urgently needed, and the challenges encountered in clinical practice.

What is the KFG MOTION researching?

Reiberger: The MOTION clinical research group, funded by the Ludwig Boltzmann Gesellschaft, focuses on liver diseases, particularly portal hypertension. Specifically, we investigate the mechanisms that trigger portal hypertension and the complications that arise from it. We analyze disease patterns and search for effective treatment solutions.

How can portal hypertension be explained?

Reiberger: The portal vein is a blood vessel that collects blood from abdominal organs — such as the stomach, intestines, and esophagus — and transports it to the liver. However, when the liver is diseased, blood cannot flow through it properly, causing a backlog, much like a hose. In this case, the backlog occurs in the portal vein. When pressure in the vein exceeds normal values, we refer to this condition as portal hypertension.

What are the causes of liver disease?

Reiberger: There are numerous causes. Excessive alcohol consumption often leads to liver scarring. However, hepatitis viruses, diabetes, or other metabolic disorders can also severely damage the liver.

Additionally, vascular diseases can affect the liver, primarily impacting the organ’s blood vessels without necessarily damaging the liver tissue itself.

What is the core focus of your clinical research group?

Reiberger: Our research revolves around three clinical studies, where we treat patients with various liver diseases: The first study focuses on patients with compensated (early-stage) liver cirrhosis. The second one targets patients with decompensated liver cirrhosis, where the disease is already in an advanced stage. The third study examines patients with vascular liver diseases, where portal hypertension arises due to increased vascular resistance.

These three groups are studied in internationally standardized clinical trials as part of our clinical research group.

What sets MOTION apart from other research groups?

Reiberger: The key difference is that our clinical research group focuses on treatment approaches for portal hypertension that are not limited to the underlying liver disease. Instead, we target mechanisms that occur across all liver diseases.

Why is this important?

Reiberger: While we have treatments for viral hepatitis infections and can implement measures to promote abstinence in alcohol-related liver disease, there is currently no universal therapy to reduce portal hypertension across all liver diseases.

That is precisely why we are researching new mechanisms and treatment approaches — independent of the underlying cause of liver disease.

Despite decades of research on portal hypertension, we currently have only one available drug therapy: non-selective beta-blockers, which have been in use since the 1980s. This alone highlights the urgent need for new therapies. Moreover, these beta-blockers reduce portal pressure in only about 50% of patients.

How does interdisciplinary collaboration play a role in the research group?

Reiberger: I am convinced that interdisciplinarity is one of the most crucial — or even THE crucial — factors for success. Without diverse perspectives from other disciplines, valuable insights would remain undiscovered.

In our clinical research group, we closely collaborate with radiology, anesthesiology, and intensive care medicine, particularly in the area of coagulation disorders, which are highly prevalent in liver diseases.

Additionally, we work with basic scientists specializing in blood vessels, allowing us to integrate these interdisciplinary perspectives to thoroughly investigate the mechanisms that will ultimately lead to new therapies for portal hypertension.

What are the biggest challenges in your work?

Reiberger: Naturally, the clinical research group faces challenges. We treat patients with severe liver diseases, so ensuring patient safety is our top priority.

Through our collaborations with other departments, we have gained extensive experience in treating these patients. Over the past year, we successfully developed patient safety-focused study protocols, which have been submitted to regulatory authorities. Now, we are ready to begin recruiting our first patients.

And in day-to-day clinical practice?

Reiberger: The rewarding yet challenging aspect of our work is the interaction with patients and colleagues.

We have an excellent research environment, with specially funded staff dedicated to conducting clinical studies.

However, patients often have acute medical issues that require immediate attention. As a result, planning, logistics, and administration take up a significant amount of time in managing and treating these conditions.

Ultimately, I am convinced that our core mission — improving therapeutic diagnostics for our patients — is what keeps our clinical research group highly motivated to achieve its goals throughout the entire research period.