Thrive by IU Health

April 08, 2022

Doctor focused on liver health: ‘I’m a big health equity champion’

IU Health University Hospital

Doctor focused on liver health: ‘I’m a big health equity champion’

IU Health’s Dr. Lauren Nephew is passionate about her role caring for some of the sickest patients. She is also keenly aware of the need for equitable access to transplantation by vulnerable patients.

By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org

Her patients talk about her open and caring spirit.

Dr. Lauren Nephew thought she wanted to focus on colorectal surgery. Then she learned she could wear many hats and still accomplish her career goals.

“As a third year medical student I was doing a colorectal rotation and was working with an amazing female surgeon. She asked me what I liked about the rotation and after listening to me, she recognized that the things I enjoyed most about the rotation were the complexities of patient disease. She said, ‘If that’s what you enjoy then you can have that and more career flexibility in gastroenterology and hepatology,’” said Dr. Nephew, who is married to Jason Nephew and the mother of two children ages three and six.

She attended Case Western Reserve University Lerner College of Medicine for medical school, completed residency at Massachusetts General Hospital and Gastroenterology and Liver Transplantation fellowships at the University of Pennsylvania. While in these post-graduate medical programs, Dr. Nephew also completed two master’s degrees in bioethics and clinical epidemiology. She has been selected as a KL2 Scholar and PLUS scholar at the Clinical and Translational Science Institute, which are programs that support outstanding researchers for their efforts in developing novel solutions focused on clinical and translational research.

She joined IU Health University Hospital and Simon Cancer Center in 2017.

“I fell in love with my patient population. Liver patients are some of the sickest patients in the hospital and have multiple other organ systems involved – their kidneys, lungs, and sometimes they have heart issues. The social complexity is an additional challenge,” said Dr. Nephew. “I like the fact that I’m involved in many aspects of the patient’s care thinking through many complex problems.”

What some may not know is that Dr. Nephew’s care extends beyond her precision skills. She is also acutely aware of the specific needs of patients who may otherwise feel marginalized.

“I am a big health equity champion and I’d like to see equitable access to transplant for vulnerable groups including racial and ethnic, minority groups and women,” said Dr. Nephew. “I’ve tried to understand why those disparities exist and the majority of my research has centered around these topics.”

In addition to research, Dr. Nephew speaks out at national conferences to bring awareness to the issue.

“There are issues with equitable access to transplant evaluation for patients and it is critical to figure out how we can be more inclusive and improve our practices,” said Dr. Nephew.

In one publication, Dr. Nephew noted racial and ethnic minorities historically have a disproportionate burden of chronic liver disease, morbidity and mortality than their White counterparts. In the same publication she notes that Black and Hispanic patients have lower rates of liver transplant referrals, and are less likely to undergo living liver donation.

In July of 2020, IU Health performed the state’s first living liver transplant in 20 years. Since then, the program has grown as a way of offering more patients with liver failure a chance to receive a life-saving donation.

“In the past two years, I’ve seen families step up. People want to help save lives. I had someone last week who was only 16 and desperately wanted to be a living liver donor for her sister,” said Dr. Nephew. In general, living liver donors should be between the ages of 18-55, and must be in good physical and mental health. They complete thorough medical and psychological evaluations. They may be related or unrelated to the recipient.

“We’ve seen several altruistic donors – people want to give to those they don’t even know. During this rough time of COVID and loss there’s a lot of giving going on and that’s a positive thing in the world,” said Dr. Nephew.

A large part of her role is educating her patients. Women tend to be reluctant to accept a living liver donor, she said.

“As mothers we’re not wired that way. We just want to be giving to others. If we have someone who needs an organ, we’ll give but if a mom needs an organ and has someone willing to give she has a tough time receiving it,” said Dr. Nephew.

As she talks about preventative care, Dr. Nephew stresses the need to consider the tough economic climate that can result in increased anxiety.

“Let’s find more ways to manage anxiety that don’t include drinking more than the recommended amount of alcohol. We’re seeing a lot of alcohol associated with liver disease,” she said. The US Department of Health and Human Services and US Department of Agriculture consider moderate drinking as limiting intake to two or less drinks a day for men and one drink or less for women.

For long-term liver health, Dr. Nephew encourages patients to focus on obesity, diabetes and metabolic syndrome. “As obesity hits younger adolescent groups, people can develop cirrhosis at an earlier age. We need to find ways to tackle that epidemic among young people and encourage making healthy foods accessible for everyone, encourage healthy eating, and physical activity,” she said.

Outside the hospital, Dr. Nephew tries to maintain work-life balance by relying on a team of family members including her husband and mother.

“I tell all working physician moms that you have to have 50-50 partners in home life and childcare,” said Dr. Nephew. She also enjoys traveling, watching movies, cooking, and she says she’s a “big news junkie.”

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Lauren D. Nephew, MD

Gastroenterology - Hepatology

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