About

Pranab Barman is an Associate Clinical Professor in the Department of Medicine at UC San Diego. His research and clinical work focus on hepatology, with particular attention to liver transplantation, hepatocellular carcinoma, and related gastrointestinal conditions. He has contributed to the field through numerous publications, including studies on steroid-induced diabetes in autoimmune hepatitis, guidance for liver transplant referrals, perioperative management for heart transplantation in patients with congenital heart disease, and outcomes of liver-kidney transplantation. His work also encompasses the assessment of cardiac risks in liver transplant candidates, the management of portal vein thrombosis, and the evaluation of body composition and bone mineral density as predictors of post-transplant survival. Barman's research extends to the treatment of hepatitis C, pharmacokinetic management in patients on anti-epileptics or mood stabilizers, and the application of image-guided therapies for hepatocellular carcinoma. His contributions are characterized by a focus on improving transplant outcomes, understanding risk factors, and optimizing treatment strategies in hepatology and transplant medicine.

Research topics

• Internal medicine
• Medicine
• Intensive care medicine
• Urology
• Cardiology
• Engineering

Selected publications

• Editorial: Steroid‐Induced Diabetes in Autoimmune Hepatitis—A Call for Treatment Optimization

  Alimentary Pharmacology & Therapeutics · 2026-02-17 · 1 citations

  articleOpen access1st authorCorresponding

  Autoimmune hepatitis (AIH) remains a management conundrum. The established approach relies upon two phases: (1) early immune suppression via rapid acting corticosteroids; (2) maintenance with azathioprine or other antimetabolite agents. While these latter agents have their own adverse effects, they play a key role in eliminating long term adverse effects secondary to chronic steroid use. This retrospective cohort study by Flatley et al. [1] offers important quantitative data on the metabolic consequences in AIH patients receiving corticosteroid therapy by following 494 patients over a median of 9 years. Conceptually, this work adds to the body of literature regarding the complications of early phase of treatment. The authors report a 15% incidence of new-onset diabetes over the study period, with higher incidence ratios in the first year. Once developed, diabetes rarely resolved even after stopping prednisolone, suggesting permanent metabolic disruption in most cases. The authors attribute this rate of diabetes development to differences in reporting frequencies, older age and extended prednisolone duration in the current study, the latter of which is a notable feature of this cohort: patients were maintained on an average prednisolone dose of 10 mg daily for 2–3 years before considering discontinuation. This may in part be due to the fact that the study cohort was initiated in 1987 and practices regarding steroid utilisation have changed considerably in the last 40 years. In fact, the American Association for the Study of Liver Disease (AASLD) Practice Guidelines [2] recommend tapering steroids by 6 months of treatment initiation. As a result, up to 50% of patients discontinuing prednisolone within twelve months have new-onset diabetes rates of < 5% [3-5]. Furthermore, new-onset diabetes and anytime-diabetes are associated with the development of cirrhosis, and new-onset diabetes is associated with liver-related death and transplantation. Prior studies have established worse outcomes in patients with diabetes and liver disease due to hepatitis C, alcohol or MASLD. However, the identification that this also exists in AIH strengthens the importance of prevention of diabetes in this population. Whether diabetes directly accelerates liver disease progression or represents a marker of disease severity and metabolic dysfunction remains to be determined. The study is limited by a retrospective single-center design. However, the comprehensive capture of patients over 36 years, access to primary data for diabetes ascertainment, and detailed outcome tracking provide advantages over some multicenter registries where complete case capture may be challenging. Perhaps the biggest limiting factor is the long study span, which, while allowing for robust patient recruitment, also introduces practice variability that may be directly contributing to higher diabetes incidence numbers. The data highlights the importance of reducing the incidence of new-onset diabetes by limiting corticosteroids regimens. Appropriately focusing on controlling hepatic inflammation, we may have underestimated the long-term metabolic cost. Earlier tapering and discontinuation following sustained complete biochemical remission is warranted. Patients with multiple diabetes risk factors might benefit from closer monitoring and more aggressive steroid-sparing strategies. The findings contribute useful quantitative data to inform evidence-based approaches to AIH therapy, regarding the balance between achieving disease remission and limiting metabolic complications. Pranab M. Barman: conceptualization, writing – original draft, writing – review and editing. The author has nothing to report. This article is linked to Flatley et al. paper. To view this article, visit https://doi.org/10.1111/apt.70188 and https://doi.org/10.1111/apt.70575. The data that support the findings of this study are available from the corresponding author upon reasonable request.

  PublisherOA PDFDOI

• Single-center perioperative management and 1-year heart transplantation outcomes for patients with adult congenital heart disease

  JHLT Open · 2025-03-07 · 1 citations

  articleOpen access

  Background: Additional data are needed to define the optimal listing strategy and peri-transplant management for adults with congenital heart disease (ACHD). In this study, we evaluated the perioperative management and 1-year outcomes for 30 patients who underwent orthotopic heart transplantation (OHT) for ACHD. Methods: We conducted a single-center retrospective case series of all patients who received an OHT at our institution for ACHD from January 1, 2017 through June 30, 2024. Descriptive statistical analyses were used to illustrate the baseline characteristics, peri-transplant management, and 1-year outcomes of participants. Results: = 28) were alive at 1 year. Conclusions: This cohort of ACHD patients had a 92.9% 1-year survival rate, consistent with other high-volume centers in the United States. In this paper, we discuss our institutional practices that address barriers to transplant for ACHD patients, such as early referral for transplant, indications for listing, pretransplant embolization of collateral vessels, and multiorgan transplant.

  PublisherOA PDFDOI

• Guidance for Timely Referral to Liver Transplantation

  Clinical Gastroenterology and Hepatology · 2025-08-01 · 1 citations

  review
  PublisherDOI

• SA11 Real-World Effectiveness and Safety of First-Line Pembrolizumab Monotherapy for Patients With Advanced or Metastatic Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

  Value in Health · 2024-06-01

  reviewOpen access
  PublisherOA PDFDOI

• CO14 Glycaemic Control, Obesity Management, and Cardiovascular Outcomes of Semaglutide for Type 2 Diabetes Mellitus Patients: An Umbrella Review of Meta-Analyses of Randomized Clinical Trials

  Value in Health · 2024-12-01 · 1 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Lessons Learned From the Liver About the Undergraduate to Graduate Medical Education Transition

  American Journal of Medicine Open · 2024-11-05

  editorialOpen access

  The burden of cirrhosis and chronic liver disease is growing, yet there is a projected worsening deficit in hepatology providers. As such, cirrhosis and liver disease have been important inclusions within the core curricula of Internal Medicine. Formal assessments of provider preparedness resulting from the curriculum are lacking though. Prior studies have demonstrated that exposure to cirrhosis in undergraduate medical education is insufficient, as are learner comfort and self-reported knowledge levels. These findings are further corroborated by a multicenter survey of incoming Internal Medicine interns showing that subjective comfort with and objective knowledge of various liver disease topics are lacking compared to other common Internal Medicine topics. This paper also demonstrates how similar surveys may be used to identify additional topics that may require adjustments for curricular improvement.

  PublisherDOI

• Opioid use and risks in candidates and recipients of liver transplant

  Liver Transplantation · 2024-04-26 · 7 citations

  reviewOpen access

  Opioid use is extremely prevalent among patients with cirrhosis and those who received liver transplant (LT), despite concerns regarding opioid-related risks in this population. While there are many theoretical risks of opioids in patients with hepatic dysfunction, there is limited evidence on the effect of opioid use on clinical outcomes in cirrhosis and patients before and after LT specifically. As a result, there is significant center-level variability in opioid-related practices and policies. The existing data-largely based on retrospective observational studies-do suggest that opioids are associated with increased health resource utilization pre-LT and post-LT and that they may precipitate HE in patients with cirrhosis and increase the risk of graft loss and death after LT. The strongest predictor of opioid use after LT is opioid use before transplant; thus, a focus on safe opioid use in the pretransplant and peritransplant periods is essential for minimizing opioid-related harms. We describe 3 strategies to guide LT providers including (1) improved characterization of pain, mental health symptoms, and opioid and polysubstance use; (2) minimization of opioid prescriptions for those at highest risk of adverse events; and (3) safe prescribing strategies for those who do use opioids and for the management of opioid use disorder. Ultimately, our goal is to improve the quality of life and transplant outcomes among patients with cirrhosis and those who received LT, particularly those living with concurrent pain, mental health, and substance use disorders.

  PublisherOA PDFDOI

• Portal vein thrombosis: Before, during, and after liver transplant

  Clinical Liver Disease · 2023-06-15 · 6 citations

  articleOpen accessSenior authorCorresponding

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  PublisherOA PDFDOI

• Nephrology for the transplant hepatologist

  Clinical Liver Disease · 2023-06-12

  articleOpen access
  PublisherOA PDFDOI

• Toolkit for the early career transplant hepatologist

  Clinical Liver Disease · 2023-03-01

  articleOpen access1st authorCorresponding

  In 2006, the American Board of Internal Medicine introduced a certification exam for transplant hepatology, followed by accredited training programs starting in 2007. This has propelled transplant hepatology into a robust and independent subspecialty within the field of gastroenterology. As a result, the number of transplant hepatology fellowships has more than tripled1 and the number of transplant hepatologists has increased 8-fold in this time period.2 Unfortunately, the increase in the workforce has not been able to keep pace with the burden of chronic liver disease, with increasing prevalence and mortality over the past 2 decades.3 This has also reflected record highs in both additions to the liver transplant waitlist (>11000) and transplants performed (>9000) in 2021.4 With improvements in surgical techniques, infection management and immunosuppression strategies, this has resulted in more transplant recipients living longer, with the 1-year survival rate steadily increasing to now exceeding 92%.5 Finally, by living longer, transplant recipients are experiencing long-term complications related to immunosuppression, including renal disease, cardiovascular disease, malignancy, and other health conditions associated with aging. Reviewing the ACGME Program Requirements for Transplant Hepatology fellowship,6 the core competencies largely revolve around evaluation and management of chronic liver disease and complications of end-stage liver disease, identification and management of hepatobiliary malignancy, principles of liver transplantation evaluation and organ allocation, and a basic understanding of the liver transplant operation and transplant immunology. However, the true practice of hepatology encompasses more than just issues related to the liver. We oftentimes find ourselves diagnosing endocrinopathies, serving as addiction counselors and discussing health care maintenance issues such as vaccinations, cancer screening and bone health. In the context of liver transplant candidacy, we are often attempting to diagnose sarcopenia and malnutrition and debating the best management strategies for hepatobiliary malignancies and mesenteric vein thromboses. Finally, transplant recipients often rely on their transplant providers to be the primary managers of metabolic and renal complications of immunosuppression, infectious issues and cancer screening procedures. These roles are in addition to the primary responsibility of managing immunosuppression, ensuring healthy graft function and providing appropriate counseling, such as in the case of a child-bearing transplant recipient. This set of articles serves as a guide for the early career transplant hepatologist to assist in diagnostic and therapeutic frameworks for various medical topics that are not necessarily formally taught during transplant hepatology fellowship. The following series of articles are meant to be practical approaches to commonly encountered clinical situations. While targeted to provide a succinct overview for trainees and early career gastroenterologists and hepatologists, the series also serves as a relevant clinical update for all practicing gastroenterologists and hepatologists caring for patients with end-stage liver disease and liver transplant recipients.

  PublisherOA PDFDOI

Frequent coauthors

• Grace L. Su

  University of Michigan–Ann Arbor

  15 shared

• Pratima Sharma

  University of Michigan–Ann Arbor

  12 shared

• Alik Farber

  12 shared

• Neehar D. Parikh

  University of Michigan–Ann Arbor

  8 shared

• Stewart C. Wang

  University of Michigan–Ann Arbor

  8 shared

• Amit G. Singal

  8 shared

• Lisa B. VanWagner

  The University of Texas Southwestern Medical Center

  7 shared

• Akbar K. Waljee

  7 shared