Hepatology & Transplant Education

The liver is the second largest organ in the body. It deserves more than a footnote in your education.

LIMES™ is a structured curriculum in hepatology and liver transplant medicine — built for medical students who want to go deeper, earlier.

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1 in 4
US adults estimated to have fatty liver disease
35%
Projected shortage in hepatology providers by 2033
62%
Transplant hepatology fellowship positions left unfilled in 2023
8
Core topics, from history-taking to transplant selection

From first principles to the transplant list

Each topic is built for the level you're at — whether you're an M1 seeing a jaundiced patient for the first time, or an M4 preparing your capstone.

Clinical Skills

How to Take a Liver-Focused History

The hepatology history has specific inflection points most standard curricula miss — alcohol quantification, herbal supplements, family history of liver disease.

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Interpretation

Interpreting Liver Enzymes

AST, ALT, ALP, GGT, bilirubin — learn the patterns that distinguish hepatocellular from cholestatic injury and when to act on mild elevations.

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Core Disease

Cirrhosis and Its Complications

The full spectrum: portal hypertension, ascites, SBP, varices, HRS, HE, and HCC surveillance — with management principles at each stage.

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Scoring Systems

The MELD Score

From TIPS trials to MELD 3.0 — the full history, formula, and clinical application of the score that determines who gets a liver.

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Transplant Medicine

Indications for Liver Transplantation

Acute liver failure, decompensated cirrhosis, HCC, and beyond — how patients are listed and what moves them up the waitlist.

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Clinical Skills

Physical Exam in Chronic Liver Disease

Spider angiomata, palmar erythema, caput medusae, shifting dullness — the findings that tell a story before the labs come back.

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Supportive Care

Nutrition in Cirrhosis

Sarcopenia is an independent predictor of mortality and waitlist dropout. Learn why nutrition is a therapeutic intervention, not an afterthought.

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Intestinal

Intestinal Failure and Transplantation

Short gut syndrome, parenteral nutrition dependence, and the rare but critical indications for intestinal transplant — a field most students never encounter.

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Hepatology is undertaught and undermatched

In 2023, 62% of transplant hepatology fellowship positions went unfilled. A projected 35% shortage of hepatology providers is expected by 2033. The problem starts in medical school.

4.9M
Americans diagnosed with cirrhosis
80%
of cirrhosis cases undiagnosed at first decompensation
777
Liver transplant physicians in the US for 106,962 prevalent transplant recipients
Rising
HCC incidence — now a leading cause of cancer-related death

LIMES™ was built to address the gap between what standard curricula cover and what future physicians — regardless of specialty — need to recognize and manage. Every internist, family physician, and emergency medicine doctor will see liver disease. This curriculum gives you the foundation to act on it.

For students, educators, and partners

Whether you're a medical student looking to go deeper, a faculty member interested in implementing a hepatology enrichment track, or an organization interested in the LIMES™ curriculum framework — we'd like to hear from you.

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