Cara Mack, MD, FAASLD
University of Colorado School of Medicine
Cara Mack discovered her calling early in her academic career. As an undergraduate at the University of Wisconsin in the 1980s, Mack envisioned working in medicine, so she decided to volunteer at the hospital on campus. She was placed in the pediatric ward, where she encountered children with liver disease for the first time. Liver transplantation was not readily available for children in that area. She saw very young patients struggling to survive. The experience was tough, but it inspired her to pursue a career in pediatrics.
"I didn’t know yet that I wanted to work in hepatology, but it’s all about what you’re exposed to and your experiences," says Dr. Mack, now Medical Director of the Pediatric Liver Center at Children’s Hospital Colorado and Professor of Pediatrics at University of Colorado School of Medicine in Aurora.
After her exposure to pediatric liver disease patients, she earned her medical degree at Loyola University Chicago and completed her residency and chief residency at the University of Chicago Comer Children’s Hospital Program. There, her early mentor Peter Whitington, MD asked her to help with his liver care team. The hospital was one of the first in the country to offer pediatric liver transplants. Seeing the dramatic improvements that pediatric patients with cholangitis or recurrent gastrointestinal bleeding from varices could make, and quickly, after transplant surgery was an eye-opening inspiration for Dr. Mack.
"I loved the complexity of caring for children with acute and chronic liver diseases. When you gave them what they needed – often it was a liver transplant – you observed how quickly they recovered and healed," she says. "Most kids didn’t develop and grow normally because of their liver disease. But once they received a new liver, they quickly started to feel better, reach developmental milestones and take on whole new personalities. That is really how I decided to go into this field." While in Chicago, she learned about AASLD and attended her first Liver Meeting. She says she was deeply impressed by the depth of the research presented there, and recognized the impact that AASLD makes to advancing hepatology knowledge.
She completed a fellowship at Northwestern University’s Lurie Children’s Hospital, where she found another mentor, Estella M. Alonso, MD, who taught her the intricacies of managing children with liver disease and exposed her to clinical research opportunities. Northwestern also offered her opportunities in public health by treating patients in underserved Chicago neighborhoods.
Seventeen years ago, Dr. Mack arrived at Children’s Hospital Colorado, where she began working with pediatric hepatologist Ronald J. Sokol, MD, FAASLD and does to this day. Dr. Mack directs a team of seven pediatric hepatologists, one of the country’s largest programs, to manage patients ranging from newborns to age 20. She divides her time between clinical work in both the inpatient and outpatient settings, and translational and basic bench research in neonatal and pediatric liver diseases. Her research passions include autoimmune-mediated liver disease and the immune system’s role in biliary atresia pathogenesis, as well as fatty liver disease, she says.
Young patients with biliary atresia and their families often travel hundreds of miles for treatment at the clinic, which serves six states. There are only 300 new cases of biliary atresia each year, or one out of every 10,000 live births in the US. Dr. Mack offers patients coming for a liver transplant a chance to be involved in her observational study for the Partners Seeking a Cure (PSC) Research Network, which she chairs. Finding the cause of biliary atresia is an urgent need, she says.
"We don’t know what causes the disease. Up to 80% of these children need a liver transplant before adulthood. Half will need a liver transplant in the first two years of life," says Dr. Mack. "We don’t yet understand why their bile ducts become inflamed and fibrosed."
Dr. Mack is also Director of the Pediatric GI, Hepatology and Nutrition Fellowship Training Program at Children's Hospital Colorado, where she mentors hepatology trainees interested in either bench or translational research in pediatric hepatology. She was named a Fellow of AASLD in 2017. "It was a great honor to be chosen. I definitely wanted to apply for it to show my support and respect for everything AASLD does, not just for professionals but for all people with chronic liver disease."
Dr. Mack and her husband, Doug, who is a PhD/scientist at the nearby University of Colorado, have two children who both attend Colorado State University: one who is studying to be an equine veterinarian and one studying business marketing. The Mack family enjoy physical activities like jogging, biking, skiing and hiking in the scenic region they call home. "The Rocky Mountains are only about an hour’s drive from us and we thoroughly enjoy last minute getaways!"