About

Marina Serper, MD, MS, is an Associate Professor of Medicine (Gastroenterology) at the Hospital of the University of Pennsylvania. She is also a Staff Physician at the Corporal Michael J. Crescenz VA Medical Center. Dr. Serper serves as the Associate Program Director of Research in the Division of Gastroenterology at the Perelman School of Medicine and is the Associate Director of the Gastroenterology Clinical Research Training Program (T32) at the University of Pennsylvania, Division of Gastroenterology and Hepatology. Her clinical expertise includes hepatitis B, hepatitis C, autoimmune liver disease, liver transplantation, hemochromatosis, and cirrhosis. Her research focuses on public health, telehealth, digital health, medication adherence, health outcomes, measurement, health literacy, healthcare quality, healthcare utilization, and public health. Dr. Serper's work aims to improve patient care and health outcomes through innovative research and clinical practice in hepatology and health services.

Research topics

• Internal medicine
• Medicine
• Psychiatry
• Gastroenterology
• Physical therapy
• Virology
• Biology
• Gerontology
• Surgery
• Intensive care medicine
• Pathology
• Genetics
• Demography
• Family medicine
• Physical medicine and rehabilitation

Selected publications

• Reply to: “Optimize hypertension management to tackle the CVD burden in MASLD”

  Journal of Hepatology · 2025-08-30 · 2 citations

  letterOpen accessSenior author
  PublisherOA PDFDOI

• From embedded interprofessional clinics to expanded alcohol-associated liver disease programs

  Liver Transplantation · 2025-05-13 · 2 citations

  article

  Hazardous alcohol use remains a major contributor to acute and chronic liver disease, while alcohol-associated liver disease (ALD) is a leading indication for liver transplantation. In recent years, embedded, interprofessional ALD clinics have improved access to alcohol use disorder care within hepatology and liver transplantation, but more work is needed to meet this challenge. The literature is lacking regarding scaling procedures to provide services for increasingly large ill patient populations. This article begins to fill this gap by describing "expanded ALD care": broad, innovative, longitudinal, interprofessional care delivery strategies surpassing standalone clinics. Drawing from analogous patient populations served by collaborative models in primary care and comprehensive eating disorder treatment, the expanded ALD care framework proposes practical strategies toward specific innovations: equipoise between biomedical and psychosocial care elements, increased clinician number and reach, long-term patient relationships, harm reduction and palliative care, outreach to external agencies and clinicians, and enhanced support for patients and families. The article also defines attributes of innovative healthcare systems that support expanded ALD care.

  PublisherDOI

• Electronic health records to test multimorbidity influences to plasma biomarker interpretation for Alzheimer’s disease

  medRxiv · 2025-08-19

  preprintOpen access

  Abstract Objective Plasma biomarkers of Alzheimer’s disease (AD) pathology are frequently tested in specialized research settings, limiting generalizability of findings. Using electronic health records and banked plasma, we evaluated plasma biomarkers – phosphorylated tau 217 (p-tau 217 ), β-amyloid 1-42/1-40 (Aβ 42 /Aβ 40 ) and p-tau 217 /Aβ 42 – in a real-world, diverse clinical population with multimorbidities. Methods Participants (n=617; 44% Black/African American; 41% female) were selected from the University of Pennsylvania Medicine BioBank with plasma assayed using Fujirebio Lumipulse. International Classification of Diseases (ICD) Ninth and Tenth Revision codes determined AD dementia (ADD; n=43), mild-cognitive impairment (MCI; n=140), unspecified/non-AD cognitive impairment (CI; n=106), and cognitively normal cases (n=328), and other medical histories. APOE ε4, body mass index (BMI), metrics of kidney function ( e.g. , eGFR), and liver disease were derived from electronic health records. Multivariable models identified factors related to plasma levels. Previously established cutpoints classified AD status (“AD+”, “AD-”, or “Intermediate”). Results Plasma p-tau 217 /Aβ 42 had the strongest association with known AD-related factors – MCI, ADD, future progression to MCI/ADD, age, and APOE ε4 – compared to p-tau 217 and Aβ 42 /Aβ 40 . Plasma p-tau 217 /Aβ 42 was also associated with eGFR, diabetes, and history of hearing loss. Importantly, AD-related factors were most frequent/severe for AD+ classification by p-tau 217 /Aβ 42 , while medical morbidities were most frequent/severe for Intermediate classification. Exploratory analyses test p-tau 217 /Aβ 42 adjusted for eGFR to eliminate its influence on plamsa levels. Interpretation In this real-world dataset, we identified effects of multimorbidities on plasma biomarkers, especially kidney function. The p-tau 217 /Aβ 42 ratio had low rates of Intermediate classification and may help to account for multimorbidity effects on plasma levels.

  PublisherOA PDFDOI

• Cause-specific mortality in patients with steatotic liver disease in the United States

  Journal of Hepatology · 2025-05-24 · 29 citations

  articleOpen accessSenior author

  BACKGROUND & AIMS: Causes of death across steatotic liver disease (SLD) subtypes remain incompletely characterized in routine clinical practice. We aimed to quantify and compare cause-specific mortality in patients with SLD. METHODS: We conducted a retrospective cohort study of adults with imaging-confirmed hepatic steatosis receiving outpatient care in the national Veterans Health Administration (2010-2021). The primary exposure was SLD subtype, including metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease (ALD), and their intersection (MetALD). The primary outcome was cause-specific mortality, stratified by baseline cirrhosis. RESULTS: Among 366,433 adults (mean age, 60.5 years; 7.7% female; 67.6% non-Hispanic White), 77.9% had MASLD, 17.5% had MetALD, and 4.6% had ALD. Over a median follow-up of 5.4 years, the 10-year cumulative incidences of cardiovascular disease (CVD)- and extrahepatic cancer-related deaths among patients without cirrhosis were 8.1% and 7.5% for MASLD, 7.5% and 7.4% for MetALD, and 8.1% and 7.4% for ALD. Among patients with cirrhosis, the 10-year cumulative incidences of liver- and CVD-related deaths were 9.2% and 17.3% for MASLD, 17.7% and 13.0% for MetALD, and 22.1% and 11.5% for ALD. Compared with non-cirrhotic MASLD (0.04 per 100 person-years), liver-related mortality was higher for MetALD (0.19 per 100 person-years; hazard ratio 3.38; 95% CI 3.02-3.78) and highest for ALD (0.40 per 100 person-years; hazard ratio 6.99; 95% CI 6.08-8.04). This progressive increase persisted in cirrhosis but was less pronounced. CONCLUSIONS: CVD and extrahepatic cancer were leading causes of death across SLD subtypes in the absence of cirrhosis, while liver- and CVD-related deaths predominated in patients with cirrhosis. MetALD and ALD were associated with progressively higher risks of liver-related mortality compared with MASLD. These findings underscore the need for integrated strategies addressing alcohol use, cardiovascular risk, and cancer screening to reduce preventable deaths. IMPACT AND IMPLICATIONS: Causes of death across the steatotic liver disease (SLD) spectrum remain incompletely characterized in routine clinical settings. In this large nationwide cohort study, we evaluated cause-specific mortality in patients with MASLD, MetALD, and ALD. We showed that cardiovascular disease and extrahepatic cancer were the primary causes of death in patients without cirrhosis across SLD subtypes, while liver disease and cardiovascular disease were predominant in those with cirrhosis. Importantly, MetALD and ALD were associated with progressively increasing risks of liver-related mortality compared to MASLD. Our findings highlight the need for integrated care models that simultaneously address cardiovascular risk factors, implement strategies to reduce alcohol consumption, and promote cancer screening to mitigate preventable deaths in SLD.

  PublisherOA PDFDOI

• SAT-498-YI Cause-specific mortality across the spectrum of steatotic liver disease: a nationwide cohort study

  Journal of Hepatology · 2025-05-01

  articleSenior author
  PublisherDOI

• Specialists and primary care physicians feel discomfort managing pain in cirrhosis and desire nonpharmacologic options

  Hepatology Communications · 2025-05-23

  articleOpen accessSenior authorCorresponding
  PublisherDOI

• Shifts in Cohort Eligibility With Deimplementation of Race-specific Guidance for Hepatocellular Carcinoma Surveillance

  Gastro Hep Advances · 2025-08-25

  articleOpen access

  Background and Aims: Clinical guidance for hepatocellular carcinoma (HCC) surveillance for patients with chronic hepatitis B virus (HBV) recently removed race from eligibility criteria, and replaced it with country of origin from a HBV-endemic country and PAGE-B score greater than 10. This study sought to determine adherence to prior race-based guidance and how demographic cohort eligibility would shift using new criteria. Methods: This was a retrospective cohort study of patients with chronic HBV with an outpatient office visit at our institution from June 1, 2022, to June 1, 2023. Patients with a personal history of cirrhosis, HCC, or comorbid viral hepatitis were excluded. HCC surveillance practices were extracted using chart review. PAGE-B scores were calculated utilizing lab data within 3 months of the office visit. Cohort eligibility for screening was compared using criteria from each guidance document. Descriptive and comparative statistics were conducted in Python. Results: Two hundred fifty-nine patients were included (51% Asian, 27% Black, and 12% White). Sixty percent (n = 156) of patients were eligible for surveillance under the race-based guidance, and clinicians adhered to this guidance by ordering surveillance in 94% of eligible cases. Under the new nonrace-based guidance, 63% would be eligible for surveillance, with discordance in surveillance eligibility in 28% of cases. Of patients who would no longer be eligible for HCC surveillance, 97% were Black. Fifty-three percent of patients who would newly warrant surveillance were White, and eligibility was primarily driven by PAGE-B score. Conclusion: Clinicians had been largely adherent to the race-based guidance. New guidance would shift cohort eligibility toward White patients, primarily due to PAGE-B criteria, with 97% of Black patients becoming no longer eligible.

  PublisherOA PDFDOI

• Process Variation in Liver, Kidney, and Pancreas Transplantation: A Multicenter Evaluation From the Consortium for the Holistic Assessment of Risk in Transplant

  Transplantation Direct · 2025-08-08

  articleOpen access

  Background: Transplant center processes for determining candidacy are complex, poorly documented, ambiguous, and variable across centers. Opaque and nonstandardized transplant processes can compromise data collection and lead to inconsistent outcomes. Methods: To understand process variation and data quality in transplantation, we surveyed 8 abdominal transplant centers in an existing research consortium about their processes of care for liver, kidney, and pancreas transplants. We used the Systems Engineering Initiative for Patient Safety model to identify variation related to people, tasks, tools, environment, and processes. Results: Centers varied in their processes across phases of transplant care, including screening referral, waitlist maintenance, and posttransplant follow-up. Regarding referrals, transplant centers chose their locations for outreach to and education for referring providers based on historical density or by request (63%). Additionally, screening of referred patients for transplant evaluation varied across centers related to screening method, screening timing/attempts, and who determines eligibility. For patients declined for listing, only 25% of centers had a formal appeal process (liver only), and most centers had either an informal appeal process (liver: 50%, kidney and pancreas: 87.5%) or none (liver: 25%, kidney and pancreas: 12.5%). Conclusions: In light of increased national attention to improving data collection, processes of care, and workforce efficiency, our findings provide insight into processes that may inform effective transplant practices and identify targets for future interventions.

  PublisherDOI

• Financial Burden and Social Needs in Solid Organ Transplant Candidates

  American Journal of Transplantation · 2025-08-01

  articleSenior author
  PublisherDOI

• The Role of Patient-Reported Outcomes in Cirrhosis

  The American Journal of Gastroenterology · 2025-05-20 · 3 citations

  articleOpen accessSenior author

  Critical to achieving the aim of person-centered care is a patient's direct report on the impact of illness and healthcare interventions on their global well-being. These reports are termed patient-reported outcomes (PROs) and defined as any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else. The aim of this review was to provide an overview of what are PROs, types of validated instruments to measure PROs in cirrhosis, and benefits of using PROs in the care of patients with cirrhosis.

  PublisherOA PDFDOI

Recent grants

• Technology Enabled Strategies to Promote Treatment Adherence in Liver Transplant: The TEST Trial

  NIH · $2.8M · 2022–2027

• Developing technology-based approaches to improve access and quality of care in cirrhosis

  NIH · $961k · 2018–2023

Frequent coauthors

• David E. Kaplan

  Hospital of the University of Pennsylvania

  442 shared

• Kimberly A. Forde

  Temple University

  299 shared

• Gina Choi

  University of California, Los Angeles

  291 shared

• Conatus Lewis

  AbbVie (United States)

  289 shared

• Jay Hoof- Nagle

  Inovio Pharmaceuticals (United States)

  289 shared

• Richard B. Roberts

  General Atomics (United States)

  289 shared

• Gregory J. Gores

  WinnMed

  289 shared

• Jay H. Hoofnagle

  National Institute of Diabetes and Digestive and Kidney Diseases

  289 shared

Labs

• Serper LabPI

Education

• Master's of Health Services and Outcomes Research

  Northwestern University

• MD, Sidney Kimmel Medical College

  Thomas Jefferson University

  2006

• Bachelor of Arts, College of Arts and Sciences

  University of Pennsylvania

  2002

Awards & honors

• American Association for the Study of Liver Diseases