Nicholas Lim, MD, loves making a “night-and-day difference” in the lives of his patients.
A University of Minnesota Health hepatologist, Lim specializes in liver care and care before and after liver transplant procedures. Though many of his patients are severely ill, Lim is motivated and optimistic when he sees improvements in their quality of life.
We asked Lim to tell us about his passion for medicine and the hurdles that many liver transplant and Hepatitis C patients continue to face when receiving the care they need.
I went to medical school in Ireland, where there’s a strong tradition of sending physicians over to the United States to do their training, especially for subspecialty training. I spent time in Vermont as a medical student and realized the U.S. is a good place for postgraduate training, because the training in the U.S. is more structured and more comprehensive. I thought this would be the best place to further my own education.
After I finished medical school, I worked for a couple years in the United Kingdom and cared for a number of patients with liver disease, including many with alcoholic liver disease, a term that encompasses cirrhosis and other alcohol-related liver issues. Because of that experience, I became more comfortable with these patients and developed an interest in treating them when I arrived in the U.S. In some cases, a liver transplant is the only way to help patients with end-stage liver disease.
Patients with cirrhosis who are in need of a liver transplant are generally very sick and may often be near death. Because there is a greater demand for liver transplants than there are available livers, not everyone is able to receive a transplant. We are still able to provide transplants for some patients. When I see them in clinic again, a few months after the transplant surgery, there can be a night-and-day difference in their health. It’s quite remarkable. Because I care for such a sick population, those moments keep me motivated and optimistic.
When I first started looking after Hepatitis C patients in the United States, the medications to treat the disease were not very effective and had major side effects. Then, gradually at first, but at a faster rate in recent years, the medications that we used to treat Hepatitis C have evolved. Now, they are a lot more effective and simpler to administer. The side effects of these new medications are almost non-existent.
Treatments and medications have improved quickly over the last couple of years, but the cost of those therapies is expensive. University of Minnesota Health providers do our best to care for all our patients and have a lot of experience working to overcome these hurdles. We believe that everybody with Hepatitis C should get the opportunity to get treated. By treating Hepatitis C, we can prevent the development of cirrhosis in our patients which in turn can avoid the need for liver transplantation in the future.
I find it really exciting that medications and treatment outcomes have changed so dramatically in the past five years. This has allowed us to give a lot of our patients hope in clearing their disease with minimum risk and harm. Hepatitis C used to be a difficult disease to treat successfully, and positive outcomes often depended on a perfect alignment of various factors. These days, the majority of patients have an excellent chance of successful treatment thanks to new medicines.