for people ages 18 years and up (full criteria)
at San Francisco, California and other locations
study started
completion around
Principal Investigator
by Sandy Feng, MD, PhD
Headshot of Sandy Feng
Sandy Feng



INTERLIVER is a prospective observational study of the relationship of the molecular phenotype of 300 liver transplant biopsies to the histologic phenotype and the clinical features and outcomes. A segment of a biopsy performed as standard-of-care for indications, or by center protocol, will be used for gene expression study.

Official Title

Diagnostic and Therapeutic Applications of Microarrays in Liver Transplantation, a Multicenter Study


The current standard for biopsy-based diagnoses of dysfunction of liver transplants is histology (the Banff system), an arbitrary international empirical consensus based on lesions and rules, similar in principle to the kidney, heart, and lung histology systems. Recent data-driven approaches using molecular and conventional technologies indicate that such systems frequently produce incorrect diagnoses - perhaps 40-50% in abnormal kidney or heart transplant biopsies and even more in lung biopsies, with great potential for harm to patients due to inappropriate treatment.

To address this unmet need and improve diagnostics in the area of organ transplantation, the Alberta Transplant Applied Genomics Centre (ATAGC, University of Alberta) has developed a new diagnostic system - the Molecular Microscope® Diagnostic System (MMDx) that interprets biopsies in terms of their molecular phenotype, and combines the molecular and histopathological features of transplant biopsies, plus clinical and laboratory parameters, to create the first Integrated Diagnostic System. The MMDx, developed first in kidney transplant biopsies because phenotypes are well established, will now be adapted to liver transplant biopsies. The present study will develop a Reference Set of liver biopsies, adapt the MMDx system to assess and report molecular phenotype of liver biopsies; and validate and refine this system in 300 unselected prospectively collected for clinical indications and a standard of care biopsies from North American and European Centers. In addition to demonstrating the real-time feasibility and potential value of this System in patient care, the study will develop and optimize a transparent and user-friendly reporting format to communicate this information to clinicians and obtain detailed feedback to improve its utility.

Thanks to increasing interest and support from participating centers, INTERLIVER has already processed 849 biopsies from 732 participants and will extend the Reference Set to 950 biopsies.


Liver Dysfunction, Liver transplant, global gene expression, molecular diagnostics, Liver Diseases, liver biopsy


You can join if…

Open to people ages 18 years and up

- biopsy for clinical indications

You CAN'T join if...

- no consent, pregnant women


  • UCSF, Transplant Research Unit accepting new patients
    San Francisco California 94143 United States
  • Division of Transplant Surgery, University of Washington accepting new patients
    Seattle Washington 98195 United States

Lead Scientist at UCSF

  • Sandy Feng, MD, PhD
    Dr. Sandy Feng is a transplant surgeon who performs liver, kidney and pancreas transplants. In her research, Feng studies transplantation tolerance, a transplant recipient's ability to maintain normal organ function with minimal or no use of immunosuppressive drugs.


accepting new patients
Start Date
Completion Date
University of Alberta
Study Type
Expecting 300 study participants
Last Updated