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 24 May 2022

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Photo of <div style=fiogf49gjkf0dWilliam Balistreri" align="left">

Dr William F. Balistreri is one of the nation's foremost authorities on pediatric gastroenterology and liver disease. He is Director of the Division of Pediatric Gastroenterology and Nutrition, and Medical Director of Liver Transplantation at the Children's Hospital Medical Center (CHMC), Cincinnati, Ohio, USA. Dr Balistreri has been caring for children with disorders of the liver and gastrointestinal tract for two decades, and was named one of the 'Best Doctors in America' in 1996 and 1998. Dr Balistreri is the first pediatrician to be elected to serve as President of the American Association for the Study of Liver Diseases (AASLD), a nonprofit, member organization, meeting the educational and scientific needs of nearly 2,300 physicians, researchers, and scientists worldwide.

Dr Balistreri received his undergraduate degree from State University of New York at Buffalo in 1976 and his medical degree from University of Buffalo School of Medicine in 1978. He was a pediatric Resident at Children's Hospital Medical Center, Cincinnati from 1971 to 1972, a post-doctoral Fellow, Division of Pediatric Gastroenterology and Nutrition, CHMC, Cincinnati from 1972 to1974, and a Research Fellow, Division of Gastroenterology, Mayo Foundation, Mayo Clinic, Rochester, Minnesota.

In 1976, Dr Balistreri was appointed Assistant Professor of Pediatrics at the University of Pennsylvania School of Medicine. In 1978, he was named Associate Professor of Pediatrics at the University of Cincinnati College of Medicine, and became an attending pediatrician and gastroenterologist at CHMC. He was appointed Director of the Division of Pediatric Gastroenterology and Nutrition, CHMC, Cincinnati, and Associate Professor of Medicine, University of Cincinnati College of Medicine in 1982. In 1983, he assumed the position as Professor of Pediatrics, University of Cincinnati College of Medicine. In 1984, he became Director of the Pediatric Liver Care Center and Dorothy M.M. Kersten Professor of Pediatrics, CHMC. In 1985, he was named Medical Director of Pediatric Liver Transplantation, CHMC, and in 1991 was appointed Professor of Medicine, University of Cincinnati College of Medicine.

He has authored over 355 publications, including original articles, editorials, reviews, and chapters in books. He has edited or co-edited several books, including the first multi-authored text on Pediatric Hepatology. He has helped to clarify the understanding of many aspects of pediatric hepatology, particularly in the areas of bile acid metabolism, neonatal cholestasis, hepatitis, and liver transplantation. Of significant importance, Dr Balistreri has a direct impact on the education of all pediatricians as Editor of the Journal of Pediatrics (1995-present). He is also Editor-in-Chief (Western Hemisphere) of the Journal of Pediatric Gastroenterology and Nutrition (1991-1995), and Co-Editor, Associate Editor, Guest Editor, Reviewer, and a member of numerous Editorial Boards of journals and periodicals.

What made you decide to become a gastroenterologist?
I 'backed into' gastroenterology. When I was a House Officer in Pediatrics at Cincinnati Children's Hospital I became interested in the complexities of metabolic liver disease. I was especially fascinated by diseases caused by 'experiments of nature', which occur when biochemical pathway are congenitally defective and malfunction. The patients we encountered offered a perspective-reducing complex biochemistry or physiology to a human problem. I therefore approached Dr Bill Schubert, who followed a large number of such patients, and asked if I could serve as a 'fellow' under his mentorship. His reply - "there is no fellowship program in pediatric liver disease or gastroenterology!" Undeterred, together we fashioned a program; I therefore became a 'GI Fellow' - a job description that evolved daily!
Who was the teacher you admired the most?
As suggested above, Bill Schubert, for his outstanding clinical acumen and scientific approach to understanding disease. As a GI Fellow my research focus, stimulated by a fascinating patient, was bile acid metabolism. I was therefore fortunate to spend time in the laboratory of Dr Alan Hofmann - a creative and innovative basic scientist who taught me the rigors of scientific investigation, and the joy of discovery
Which research paper influenced you the most?
'Bile acid malabsorption caused by ileal resection' by Alan Hofmann (Arch Intern Med 130:597-605, 1972). This detailed the physiology of the enterohepatic circulation (EHC) of bile acids and indicated the consequences of alterations in the EHC. This paper stimulated me to envision congenital defects in the EHC of bile acids and the resultant clinical phenotypes, and to embark on a very rewarding series of investigations over the next 28 years!
What is the most important fact that you have discovered?
That the key to understanding complex or enigmatic disease is to think metabolic! This has led not only to the discovery of new diseases, but also to the ability to directly treat children afflicted with various metabolic liver disease by replacing a deficient end-product or by inhibiting a key enzymatic process.
What is your unfulfilled ambition?
To see the creation of successful multi-center research programs in pediatric liver disease.
What is your greatest regret?
That I never learned to say "no"- life would be so much simpler without deadlines!
How do you relax?
I enjoy running in local races with my wife, Becky, and my daughter, Jenny, and skiing with my son, Bill. I also enjoy discussing cases (long-distance) with my son, Tony, a Fellow in Gastroenterology
What is your favorite sport?
For participation - running and skiing. For vicarious viewing - amateur athletics (especially intercollegiate sports such as lacrosse).
What are your best places in the world?
(1) Yellowstone National Park; (2) Taormina, Sicily; (3) Aspen, Colorado; (4) Cincinnati, Ohio; and (5) any place with fresh powder for skiing!
What are your favorite films?
"Casablanca", "On the Waterfront", "The Grand Illusion", and "Animal House"!
What car do you drive?
Honda Accord (vintage 1997).
What is your best electronic 'toy'?
My garage door opener - simple (one button does it all)!
What book are you reading at the moment?
"The Worst Case Scenario Survival Handbook" by Joshua Piven and David Borgenicht.
Why did you get in involved in
I view this as an opportunity to add a unique perspective - that of a pediatric hepatologist/gastroenterologist. I had the good fortune of being involved in the early years of our sub-specialty. As I mentioned above, when I began my training, my fellowship was basically an unstructured apprenticeship with undefined and unlimited boundaries. The field has grown to encompass highly structured fellowship programs, which result in board certification. The science and clinical practice of pediatric gastroenterology and hepatology have grown apace - never has there been a more exciting time in our sub-specialty. We have tools to investigate and to heal. Understanding of human biology will enable us all to define the molecular basis of complex diseases at the level of interacting genes and gene regulation. Significant challenges remain - diseases such as biliary atresia should serve as a stimulus to all of us to devote our thoughts to patient oriented research. I believe that rapid and precise dissemination of new and important information is key - is the ideal vehicle!

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Roy Pounder (London)

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