Reflections on the first five years of Hepatology , 1981-1986
Authors: Irwin M. Arias
Journal: Hepatology (2006)

“It was the best of times. It was the worst of times”. It was post-Vietnam, President Jimmy Carter, Iran hostages, Elvis, Star Wars IV, New York City blackout, Johnstown flood, and Barry Blumberg winning the Nobel Prize for discovering hepatitis B virus (HBV). Like the rest of the world, hepatology was also stirring. In the late 1970s, discussions at AASLD Council meetings focused on difficulties in publishing liver-related papers in a single major journal. Several Council members, notably Marcus Rothschild and Hans Popper, often raised the possibility of creating a new journal exclusively for liver biology and disease. A relatively small number of liver papers were regularly published in Gastroenterology; however, liver research was generating substantial numbers of outstanding papers that, as later documented by Harold Conn (1:85, 1981), were published in many basic science and clinical journals throughout the world. In February 1979, the midwinter AASLD Council Retreat made a significant advance! The major topic was “Should we have a liver journal?” Discussions were long, thoughtful and, at times, passionate. Two days of steady rain contributed by deflecting outside diversions. Council deliberations focused on negotiations with the AGA to improve the situation. In mid-1979, the AASLD Publications Committee, represented by Harold Conn, Harold Fallon, and myself, met with Fred Kern, Mort Grossman, and John Fordtran who represented the AGA and Gastroenterology. The discussions were in-depth but did not resolve the major concerns. The hepatologists wanted a role in editorial selection and increased publication of liver papers, which was deemed impossible due to limited publication space. In addition, the AGA group feared fragmentation of Gastroenterology as a journal and long-term effects on the professional discipline. At the conclusion of the meeting, the AASLD committee drafted a proposal recommending creation of a new journal devoted exclusively to liver biology and disease. In November 1979, the Council unanimously voted to create a new journal, and the search for an editor and publisher began. With considerable help from Willis Maddrey, Michael Sorrell and other members of the Publications Committee, Williams and Wilkins was selected as the journal's first publisher. Having recently lost the contract to publish Gastroenterology, Williams and Wilkins were cooperative and approved a contract in August 1980, in which AASLD retained the journal's title. Subsequently, AASLD members voted and overwhelmingly approved support for the journal through subscriptions linked to an increase in annual dues that covered editorial as well as publication costs. Within a few years, the journal generated increasing and, eventually, substantial income for the AASLD. In midwinter of 1980, I was fortunate to be given the challenge to organize and edit the new journal. The original name proposed was The Liver; however, this name had recently been contracted by European pathologists. Hepatology was then proposed and accepted. I do not remember why the journal's cover was green. It may have had something to do with bile pigments, a field in which I was greatly involved in those days! (Yellow was too gauche!). Starting a journal from scratch was a heady chore, particularly when we were requested to have the first issue published by January–February 1981, which allowed approximately 9 months in which to organize the journal and provide manuscripts for the first issue. Doubts were expressed by some as to our success as well as concerns about the effect of a liver journal on Gastroenterology, both the journal and the discipline. None of these fears materialized. In fact, the new journal and the old journal flourished and continue to do so. A highlight in creating Hepatology was the recruitment of outstanding Associate Editors who were given editorial responsibility for accepting manuscripts. This was long before the days of rapid electronic communication. Mail and telephones were standard fare of the day. The founding Associate Editors were Hal Conn, Jim Boyer, Tom Edgington, Bill Jakoby, Saul Krugman, Hans Popper and Dave Shafritz. Charles Davidson was the Book Editor. Ms. Ada Gelnick was recruited as editorial assistant. All did outstanding jobs and participated equally in establishing Hepatology as a quality journal. Because this effort was de novo, we were given considerable latitude in all aspects of the publication. To enhance the reputation and scope of the new journal, 58 leading basic and clinical hepatologists from around the world were recruited to serve as the Editorial Board. Each responded to the cause and contributed articles and/or reviews, served as reviewers and promoted the journal worldwide. The outlook of Hepatology was global from the beginning, as recognized in a gracious and encouraging letter from Kunio Okuda, who was President of the IASLD (1:1, 87, 1981). The immediate goal was to develop a national and international liver journal that included basic and clinical dimensions of hepatology. Another major objective was to bridge the ever-increasing gap between the amazing advances in biology and their application to liver physiology and disease, thereby linking hepatologists and basic scientists. It was acknowledged that, through the AGA, Gastroenterology led the way and that, through the AASLD, Hepatology sought to enlarge the effort. The first editorial in Hepatology drew attention to the exciting world in which the journal emerged. “Studies of liver physiology and disease are only beginning to experience the effect of modern cellular and molecular biology, immunology, genetics and pharmacology. It requires little imagination to realize that the future will see direct applications of cloning, molecular hybridization, genetic engineering, advanced technology, membrane and receptor biology, collagen and biomatrix physiology and other advances of the scientific revolution which we are fortunate enough to be witnessing. … It is clear that these advances will profoundly change our discipline, alter our teaching and research; and underlie advances in pathophysiology, diagnosis and treatment… We will strive to have Hepatology reflect all dimensions of the remarkable organ which attracts our interest” (1:84, 1981). Few of us realized that, despite this seemingly expansive vision of the future, it was, in fact, myopic. The amazing advances in science were not the result of a singular advent (i.e., molecular biology) but were sustained by fundamental discoveries which continue to this day. Both the Journal and the discipline of Hepatology continue to build strong bridges between basic science and their application to medicine. The first 5 years of Hepatology took place during the first great wave of this process. It was an exciting and proper time for a new liver journal to appear. Almost every issue had a review and/or editorial by a leading basic scientist who was not identified as a hepatologist but whose work profoundly influenced our discipline. Topics included, among others, hepatitis virology, oncogenes and regeneration, collagen biology and fibrosis, autoimmunity, membrane receptors and signaling mechanisms, and remarkably prescient reviews on aging, virally mediated carcinogenesis, embryology, apoptosis, and hepatic heat shock proteins. Topics of interest have not changed, although major advances have shifted the focus to more reductionist inquiry. Hepatology was not intended to be a basic science journal but rather a bridge between medicine and basic science. This is illustrated by the first article in Hepatology in which David Shafritz and Michael Kew reported integration of HBV DNA into the host genome in hepatocellular cancer and, in the fifth issue, the final report of a controlled clinical trial by Wolf Szmuness and colleagues on the efficacy of the hepatitis B vaccine. This report was hailed as a model for randomized, double-blind, placebo-controlled trials. Its effect was profound. From 1981 to 1986, Hepatology appeared 6 times per year, with approximately 700 printed pages per year. Each issue contained 10 to 12 original articles, 2 invited reviews and 1 to 2 editorials. Major books related to the liver were regularly reviewed. During the leadership of subsequent Editors, an increasing number of excellent articles were submitted, which increased the work load; electronic communication appeared, and Hepatology became a monthly journal to accommodate its status as the leading liver journal worldwide. The goals, standards, and format of the journal have not changed, although, somewhere along the line, book reviews suddenly disappeared, a loss I regret. By end of the first year, the Journal was well-received globally, as evidenced by increased international subscribers and basic science and clinical manuscripts. The acceptance rate declined to about 25% and the citation index rapidly increased. The editors met annually at the time of the AASLD meeting. Our expenses were virtually nil. No one received payment in any form. These were exciting days. Basic science and hepatology were rapidly changing. Serving as Editor of Hepatology for its first 5 years was a highlight of my professional life. I am forever thankful to the AASLD, Associate Editors, reviewers, and, above all, contributors whose research continuously changes our discipline. When the journal moved from the Bronx to Texas in 1986, Ada Gelnick wisely reflected that “Creating a new journal is probably the closest a man can get to parturition.” Right on!