A brief history of the meetings of the Spanish Association for the Study of the Liver (1967–2015)

In February 2015, the 40th conference of Spanish hepatologists took place in Madrid, Spain. To mark this anniversary, the board of directors of the Spanish Association for the Study of the Liver (AEEH) invited all conference attendees to a gala dinner in the Casino de Madrid, at which I was given the opportunity to present the history of AEEH conferences. I sincerely appreciated the invitation because, with the exception of the founding conference in 1967, I have attended all the conferences held so far–actively participating in most of them–and I feel that my membership of the AEEH has instilled in me the feeling of forming part of one big family, and has been key to my professional development. Networking with colleagues (who usually become friends), the scientific discussions, the encouragement to learn more and the teaching obligations have become for me a constant source of gratification. I took this presentation, therefore, as the chance to pay tribute to the Spanish hepatologists who have helped make the AEEH the exemplary organisation it is today.

The creation of the AEEH can be attributed to professor Manuel Díaz Rubio (1908–1976)¹ (Fig. 1), professor of Medical Pathology in the Faculty of Medicine in Madrid. It was he who, in the mid-1960s, brought together a select group of Spanish physicians–gastroenterologists and internists interested in liver diseases–to discuss the latest developments in this field of medical pathology in a conference. Díaz Rubio was highly regarded as an expert in liver disease, having studied under professor Hans Eppinger in Vienna and conducted research in the field of viral hepatitis and cirrhosis.^2,3 The meeting took place in Madrid in 1967, with a total of 44 speakers taking part. At an assembly celebrated at the end of the meeting, the attendees welcomed Díaz Rubio's proposal to form a scientific society dedicated to the study of the liver. It would be called the Spanish Association of Hepatology (AEH), and would meet every 2 years to discuss scientific advances and to make proposals for collaborations between Spanish experts.

Figure 1.

Prof. Manuel Díaz Rubio (1908–1976).

At that time, hepatology was only a branch of gastroenterology and received scant attention in studies in medical pathology. In more scientifically advanced countries, few hospitals included a service dedicated to liver patients, the aetiology of most liver diseases was unknown, and few drugs with therapeutic value were available. Laparoscopy and liver biopsy were the only diagnostic methods available. In Spain at that time, some modest teaching initiatives had been launched to present the state of the knowledge on the diagnosis and treatment of liver diseases, as Dr. Ramón Bataller Sifré reported in his brief summary of the creation of the AEH published some years ago.⁴

The attendees were satisfied with the meeting and elected the first AEH board of directors, which was chaired by M. Díaz Rubio, with 3 vice-chairs: C. Marina Fiol, F.J. García Conde and M. Hidalgo; a secretary, A. Guarner; a treasurer, J.L. Goñi, and 5 members: F. Andreu Kern, F. Conchillo, R. Mora, I. Serés and A. Varela.

The next meeting also took place in Madrid 2 years later and, like the first, was chaired by professor Díaz Rubio and organised in the form of round tables with 4 or 5 speakers presenting different aspects of the core topics. The topics at that meeting were: dysglobulinaemic cirrhoses, cirrhosis and diabetes, chronic acalculous cholecystitis, cardiac liver and renal function in chronic liver diseases. In 1971, the meeting was held in Seville, chaired by Fernando Andreu Kern. This was the first in a series of itinerant biannual meetings held in Spanish cities where there was a physician interested in hepatology who was capable of organising the conference. The conference celebrated in Barcelona in 1973 was chaired by Francisco Vilardell Viñas, head of the gastroenterology department in the Hospital de San Pablo. The following biannual meetings were held in Tenerife in 1975, chaired by Pedro de las Casas Alonso, head of the gastroenterology department in the Hospital Nuestra Señora de la Candelaria; in Valencia in 1977, chaired by Joaquín Berenguer Lapuerta, head of the gastroenterology department in the Hospital de La Fe; in San Sebastian in 1979, chaired by José Ignacio Arenas Miravé, head of the gastroenterology department in the Hospital Virgen de Aránzazu; in Oviedo in 1981, chaired by José María Arribas Castrillo, head of the internal medicine department in the Hospital Central de Asturias; and in Pamplona in 1985, chaired by professor of medical pathology Jesús Prieto Valtueña, of the Clínica Universitaria de Navarra.

In Pamplona, the AEH assembly agreed a series of proposals put forward by Juan Rodés which, although considered very important, have probably only had an indirect impact on the development of Spanish hepatology: 1) to celebrate the conferences annually, which meant increasing the frequency of contacts and positive incentives that these entailed; 2) to do so in Madrid, in a hotel, in order to enable doctors from all over Spain to attend the event, make better use of the time available, reduce the temptation to go sightseeing, and to make the most of the conference; 3) to give the board of directors the responsibility of organising the conference and setting the agenda in order to make this as professional as possible; 4) to eliminate the round tables and replace them with papers selected by an ad hoc commission elected by the assembly, with a discussion after each one; 5) to include a poster session to present papers that could not be included in the general sessions; 6) to include a keynote lecture given by an invited foreign expert (Table 1); 7) to award 2 grants annually: the Juan Rodés grant and the Carlos Hernández Guío grant, to young members of the AEEH with an educational project that involved a 1-year stay in a centre in a foreign country or a shorter stay in Spain to learn a research technique. More activities have been added to the conferences over the years, such as a pre-conference training course for resident physicians, and satellite symposia sponsored by the pharmaceutical industry.

Table 1.

Chairmen of the AEEH.

1867–1973 Manuel Díaz Rubio, Hospital Clínico, Madrid

1973–1977 Carlos Marina Fiol, Clínica de la Concepción, Madrid

1977–1981 Fernando Andreu Kern, Hospital Virgen del Rocío, Seville

1981–1985 Carlos Hernández Guío, Clínica de la Concepción, Madrid

1985–1989 Juan Rodés Teixidor, Hospital Clínic, Barcelona

1989–1993 Pedro Escartín Marín, Clínica Puerta de Hierro, Madrid

1993–1997 Miguel Bruguera Cortada, Hospital Clínic, Barcelona

1997–2001 Joaquín Berenguer Lapuerta, Hospital la Fe, Valencia

2001–2005 Jesús M. Prieto Valtueña, Clínica Universitaria, Pamplona

2005–2009 Vicente Arroyo Pérez, Hospital Clínic, Barcelona

2009–2011 Fernando Pons Romero, Hospital Valdecilla, Santander

2011–2013 Rafael Esteban Mur, Hospital Valle de Hebrón, Barcelona

2013–2015 Jaime Bosch Genover, Hospital Clínic, Barcelona

During the early years of the AEH, the tenure of the chairperson elected, like the members of the board of directors, by an assembly held at the end of each conference, was 4 years, but was reduced to 2 years from 2009. Table 2 lists the names and work places of the different AEH chairpersons. The association changed its name at the start of the 1980s to the Spanish Association for the Study of the Liver (AEEH) to bring it in line with the Pan-European association (European Association for the Study of the Liver [EASL]) and the different European national associations.

Table 2.

Keynote speakers at AEEH conferences.

Year	Guest	Place of work
1979	Jean Pierre Benhamou	Paris
1981	Michel Roggendorf	Munich
1983	Hector Orrego	Toronto
1985	Christian Trepo	Lyon
1986	Jorge Gumucio
1987	?
1988	?
1989	Irving M Arias	Boston
1900	?
1991	Rafael Esteban	Barcelona
1992	Jorge Rakela	Rochester
1993	Alfredo Alberti	Padua
1994	Andrés Blei	Chicago
1995	Valeer J Desmet	Louvain
1996	Mario Rizzetto	Torino
1997	Marcos Rojkind	New York
1998	Dominique Larrey	Paris
1999	Jaime Bosch	Barcelona
2000	Carlos O. Esquivel	Pittsburgh
2001	JM Pawlotski	Paris
2002	Oliver FW James	Newcastle-upon-Tyne
2003	Rafael Esteban	Barcelona
2004	?
2005	Valeer J Desmet
2006	Rajiv Jalan	London
2007	Barbara Reherman	Bethesda
2008	Michael Trauner	Graz
2009	Michael Manns	Hannover
2010	Patrick Kamath	Rochester
2011	Armando Tripodi	Milan
2012	Massimo Colombo	Milan
2013	Steffano Bellentani	Modena
2014	Laurent Castera	Paris

During the early years, the AEEH was statutorily a subsidiary of the Spanish Society of Gastroenterology (SEPD), which never approved the creation of an independent scientific society dedicated to a field that they considered part of their own. Over the years, this inflexibility was relaxed, and ultimately the AEEH severed its link with the SEPD to become a fully independent society.⁵

Striking changes in the composition of the AEEH and the conference agendas have occurred over the years. Notably, the AEEH has gradually included more female members. The first presentation made by a female doctor took place at the 4th meeting, celebrated in Barcelona in 1973: a paper presented by Dr. Teresa Sala, an endoscopist at the Hospital de la Fe in Valencia. At the meeting in Pamplona in 1985, there were 3 female speakers: Drs. María Buti, from the Hospital del Valle de Hebrón, Barcelona, María Pilar Civeira, from the Clínica Universitaria de Pamplona, and María Guadalupe Ercilla, from the Hospital Clínico de Barcelona. Following this, the number of female physicians presenting papers has continued to grow, until the conferences held this century have included an equal number of papers presented by both sexes, although in 2013 there were more presentations made by female doctors (74%). This reflects the present percentage distribution of male and female doctors in Spanish hospitals.

Another notable development in the history of AEEH conferences has been a gradual increase in the number of collaborative or multicentre papers presented. At the early meetings, all the papers presented came from a single department. The 1980s in Spain saw the start of the tradition of writing papers that combined the clinical experience, or the outcomes, of research projects carried out by groups working in different hospitals. This trend has grown markedly over the years. Eleven collaborative papers were presented at the general session in the 1980s, 40 in the 1990s and 95 in the first decade of this century.

It is also important to highlight the willingness of the AEEH, through its board of directors, to recognise the work and dedication to the association of its most prominent members by organising tributes to particular individuals. In these sessions, one of the Association's most veteran members, chosen by the board, summarises the work of the honouree. Drs. Pedro Escartín Marín (Fig. 2), who was presented by Agustín Albillos, and Joaquín Berenguer Lapuerta (Fig. 3), presented by Miguel Bruguera, were honoured in 2007; Drs. José Antonio Solís Herruzo (Fig. 4), presented by Ricardo Moreno, and Miguel Bruguera Cortada (Fig. 5), presented by Juan Cabrera, were honoured in 2008; Dr. Ricardo Moreno Otero (Fig. 6), presented by María Luisa García Buey, was honoured in 2013.

Figure 2.

Pedro Escartín Marín.

Figure 3.

Joaquín Berenguer Lapuerta.

Figure 4.

Miguel Bruguera Cortada.

Figure 5.

José Antonio Solís Herruzo.

Figure 6.

Ricardo Moreno Otero.

Perhaps one of the most important tributes paid by the AEEH was the session organised in 2003 to honour the man who has been behind many of the initiatives carried out in the field of hepatology in Spain, Dr. Juan Rodés Teixidor, on the occasion of his 65th birthday (Fig. 7). During the conference, which took place exceptionally that year in Barcelona in order to be able to honour Dr. Rodés, a dinner was held in the oval room of Montjuïc palace in which the speakers described the fundamental role of Rodés in promoting the society's initiatives, in converting the AEEH into an international scientific forum and a space for young Spanish researchers to present their work. The speakers at this event — the chairman of the AEEH at that time, Jesús Prieto, and myself — highlighted the human, professional and academic merits of Rodés.

Figure 7.

Juan Rodés Teixidor.

The AEEH conferences have contributed significantly to improving the quality of both clinical practice and research in hepatology in Spain. They have stimulated scientific cooperation between centres and have become a forum where residents and young doctors from various hospitals can present their work. They have made an important contribution to continuing professional development in the field of hepatology, and have fostered friendships between colleagues, all of which has improved the care of patients with liver disease in Spain. They have also provided a platform for hepatologists of international prestige to showcase their work, bringing these admired experts closer to young Spanish doctors and enriching their experience. Table 1, which includes the name of the keynote speakers, shows that the researchers who have helped shape our knowledge of the speciality have been included in the AEEH conferences.

In the period between the 1st and 40th conference, some members of the AEEH have died, among them all the members of the first board of directors of the AEH, with the exception of Dr. Isidro Serés, who is fortunately still with us at 91 years of age. Some members died before their time, while they were still fully engaged in the association and expected to make major contributions to science. As a tribute from myself and the AEEH, I would like to mention Drs.: Gonzalo Miño (1938–2002), head of the gastroenterology department in the Hospital Reina Sofía, Córdoba⁶; Miguel Pérez Mateo (1949–2002), head of the internal medicine department, Hospital General de Alicante⁷; and Joan Córdoba (1964–2014), consultant in the hepatology department in the Hospital del Valle de Hebrón, Barcelona,⁸ who were major elements in the growth of the AEEH.

Conflict of interests

The author declares that he has no conflict of interests.

Acknowledgements

I thank Drs. Jaime Bosch and José Luis Calleja, for making me put my thoughts in order to present the history of the first 40 conferences of the AEEH at the meeting celebrated in February 2015, which I have used as a basis for this article. Also, Drs. Vicente Arroyo, José Aguilar Reina and Antoni Mas, who refreshed my memory while I was writing this text, and Drs. Manuel Díaz-Rubio García, Agustín Albillos and Manuel de la Mata and Mr. Javier Micieces, who readily provided the information I requested to write this article.