Dr. Mª Pilar Ballester Ferré

Emerging Investigator
Research Group on Neurological Impairment


Graduate in Medicine and Surgery at the University of Valencia and specialist in Gastroenterology and Hepatology at the University Clinical Hospital of Valencia. During her degree, she obtained a collaboration scholarship with the Department of Physiology of the Faculty of Medicine of the University of Valencia. She completed the master’s degree in “Research in Clinical Medicine” from the University Miguel Hernández of Elche. She received a Rio Hortega contract (CM19/00011) from the Instituto de Salud Carlos III that allowed her to combine her training in clinical and translational research with healthcare activity in the Digestive Disease Department of the University Clinical Hospital of Valencia. She obtained her PhD in Medicine in February 2021, focused on the study of immune dysfunction associated with minimal hepatic encephalopathy in patients with cirrhosis, with “cum laude” mention and extraordinary doctorate award from the University of Valencia. She completed a predoctoral stay at the University of Pittsburgh Medical Center, USA, an international reference center in liver transplantation, under the supervision of Dr. Ramón Bataller. For this stay she received funding from Sociedad Valenciana de Patología Digestiva (SVPD) and INCLIVA Health Research Institute. She subsequently completed a postdoctoral stay at University College London, United Kingdom, supervised by Dr. Rajiv Jalan, for which she also received funding from INCLIVA Health Research Institute. During this stay she studied the role of ammonia in the pathogenesis and treatment of complications of cirrhosis, with the creation of the European AMMON consortium, which she currently coordinates. She has recently received the Juan Córdoba scholarship from the Spanish Association for the Study of the Liver (AEEH) to continue advancing in the study of complications of cirrhosis and has applied for her first patent through University College London. She has collaborated in 3 competitive projects from Instituto de Salud Carlos III, Ramón Areces Foundation and Prometeo Program of Generalitat Valenciana and has received her first FIS project as principal investigator for 2024. She was one of the founders of the Young Group of the Spanish Association of Gastroenterology (AEG) and during 4 years she was part of its scientific committee. She is currently part of the translational scientific committee of the International Society of Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) and is a member of the European Association for the Study of the Liver (EASL). As a result, she has presented more than 70 abstracts at national and international conferences with awards for the best poster and oral presentation at SVPD conference in 2016 and 2018, respectively. She has published 30 scientific articles with 50% as first author and 40% as corresponding, 53% of them in Q1 journals. At the same time, she has performed teaching tasks with co-tutoring of 5 final degree projects, 1 final master’s project and 2 PhDs.

Dr. Mª Pilar Ballester Ferré

mapibafe@gmail.com; ballester_marfer1@gva.es

Improved cognition after rifaximin treatment is associated with changes in intra- and inter-brain network functional connectivity. Casanova-Ferrer F, Gallego J, Fiorillo A, Urios A, Rios M, Leon J, Ballester M, Escudero-Garcia D, Kosenko E, Belloch V, Montoliu C. Journal of Translational Medicine. 2024 Jan 12;22(1):49. doi: 10.1186/s12967-023-04844-7. PMID: 38217008

Biological treatment interruption in Inflammatory Bowel Disease: motivation and predictive factors. González MRD, Ballester MP, Romero-González E, Sánchez-Pardo AM, Marti-Aguado D, Tosca J, Suria C, Ausejo RA, Moreno IP, Silvestre MDP, Pérez MM, Bosca-Watts MM. Gastroenterologia y Hepatologia. 2023 Nov;46(9):671-681. doi: 10.1016/j.gastrohep.2022.10.021. PMID: 36375696

Corrigendum to Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis [J Hepatol 79(4) (2023 Oct) 967-976]. Ballester MP, Tranah TH, Balcar L, Fiorillo A, Ampuero J, Kerbert AJC, Thomsen KL, Escudero MD, Mandorfer M, Reiberger T, Shawcross DL, Romero-Gómez M, Montoliu C, Carbonell-Asins JA, Jalan R. Journal of Hepatology. 2023 Dec;79(6):1571. doi: 10.1016/j.jhep.2023.10.013. PMID: 37919110

Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis. Ballester M, Tranah T, Balcar L, Fiorillo A, Ampuero J, Kerbert A, Thomsen K, Escudero M, Mandorfer M, Reiberger T, Shawcross D, Romero-Gomez M, Montoliu C, Carbonell-Asins J, Jalan R. Journal of Hepatology. 2023 Oct;79(4):967-976. doi: 10.1016/j.jhep.2023.05.022. PMID: 37277075

Extracorporeal liver support and liver transplantation for acute-on-chronic liver failure. Ballester M, Elshabrawi A, Jalan R. Liver International. 2023 Jun 14. doi: 10.1111/liv.15647. PMID: 37312660

Letter to the Editor – Reply to ‘Ammonia – an old friend with a new area of application. Tranah TH, Ballester MP, Carbonell-Asins JA, Jalan R, Shawcross DL. Journal of Hepatology. 2023 Jan;78(1):e23-e26. doi: 10.1016/j.jhep.2022.09.023. PMID: 36216137

Measuring and interpreting ammonia levels in cirrhosis. Ballester M, Rose C, Carbonell-Asins J, Jalan R. The American Journal of Gastroenterology. 2023 Jul 1;118(7):1297. doi: 10.14309/ajg.0000000000002245. PMID: 37377264

Mild cognitive impairment is associated with enhanced activation of Th17 lymphocytes in non-alcoholic fatty liver disease. Fiorillo A, Gallego J, Casanova-Ferrer F, Gimenez-Garzo C, Urios A, Ballester M, Durban L, Rios M, Megias J, San Miguel T, Kosenko E, Escudero-Garcia D, Benlloch S, Felipo V, Montoliu C. International Journal of Molecular Sciences. 2023 Jun 20;24(12):10407. doi: 10.3390/ijms241210407. PMID: 37373554

Neurofilament light chain protein in plasma and extracellular vesicles is associated with minimal hepatic encephalopathy and responses to rifaximin treatment in cirrhotic patients. Fiorillo A, Gallego J, Casanova-Ferrer F, Urios A, Ballester M, San Miguel T, Megias J, Kosenko E, Tosca J, Rios M, Escudero-Garcia D, Montoliu C. International Journal of Molecular Sciences. 2023 Sep 29;24(19):14727. doi: 10.3390/ijms241914727. PMID: 37834174

Randomized, controlled clinical trial of the DIALIVE liver dialysis device versus standard of care in patients with acute-on- chronic liver failure. Agarwal B, Canizares R, Saliba F, Ballester M, Tomescu D, Martin D, Stadlbauer V, Wright G, Sheikh M, Morgan C, Alzola C, Lavin P, Green D, Kumar R, Sacleux S, Schilcher G, Koball S, Tudor A, Minten J, Domenech G, Aragones J, Oettl K, Paar M, Waterstradt K, Bode-Boger S, Ibanez-Samaniego L, Gander A, Ramos C, Chivu A, Stange J, Lamprecht G, Sanchez M, Mookerjee R, Davenport A, Davies N, Pavesi M, Andreola F, Albillos A, Cordingley J, Schmidt H, Carbonell-Asins J, Arroyo V, Fernandez J, Mitzner S, Jalan R. Journal of Hepatology. 2023 Jul;79(1):79-92. doi: 10.1016/j.jhep.2023.03.013. PMID: 37268222

Reply to ‘Ammonia and prognosis of cirrhosis: a new perspective for identifying high risk patients’. Tranah T, Ballester M, Carbonell-Asins J, Jalan R, Shawcross D. Journal of Hepatology. 2023 Feb;78(2):e70-e71. doi: 10.1016/j.jhep.2022.10.025. PMID: 36334687

Reply to ‘The possible link between higher ammonia levels associated with non-alcoholic fatty liver related cirrhosis and diabetes: are we missing chronic kidney disease?’. Tranah T, Ballester M, Carbonell-Asins J, Jalan R, Shawcross D. Journal of Hepatology. 2023 Feb;78(2):e73-e74. doi: 10.1016/j.jhep.2022.10.024. PMID: 36332694

Reply to: Ammonia predicts clinical outcomes in cirrhosis – but there are caveats to consider. Ballester M, Carbonell-Asins J, Balcar L, Reiberger T, Jalan R. Journal of Hepatology. 2023 Dec;79(6):e239-e241. doi: 10.1016/j.jhep.2023.08.015. PMID: 37625482

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant. Mehta G, Riva A, Ballester M, Uson E, Pujadas M, Carvalho-Gomes A, Sahuco I, Bono A, D’Amico F, Viganò R, Diago E, Lanseros B, Inglese E, Vazquez D, Sharma R, Tsou H, Harris N, Broekhoven A, Kikkert M, Morales S, Myeni S, Riveiro-Barciela M, Palom A, Zeni N, Brocca A, Cussigh A, Cmet S, Escudero-García D, Stocco M, Natola L, Ieluzzi D, Paon V, Sangiovanni A, Farina E, di Benedetto C, Sánchez-Torrijos Y, Lucena-Varela A, Román E, Sánchez E, Sánchez-Aldehuelo R, López-Cardona J, Canas-Perez I, Eastgate C, Jeyanesan D, Morocho A, Di Cola S, Lapenna L, Zaccherini G, Bongiovanni D, Zanaga P, Sayaf K, Hossain S, Crespo J, Robles-Díaz M, Madejón A, Degroote H, Fernández J, Korenjak M, Verhelst X, García-Samaniego J, Andrade R, Iruzubieta P, Wright G, Caraceni P, Merli M, Patel V, Gander A, Albillos A, Soriano G, Donato M, Sacerdoti D, Toniutto P, Buti M, Duvoux C, Grossi P, Berg T, Polak W, Puoti M, Bosch-Comas A, Belli L, Burra P, Russo F, Coenraad M, Calleja J, Perricone G, Berenguer M, Claria J, Moreau R, Arroyo V, Angeli P, Sánchez C, Ampuero J, Piano S, Chokshi S, Jalan R. Hepatology Communications. 2023 Oct 18;7(11):e0273. doi: 10.1097/HC9.0000000000000273. PMID: 37870985

Vaccination in liver diseases and liver Transplantation: Recommendations, implications and opportunities in the post-covid era. Ballester M, Jalan R, Mehta G. JHEP Reports: Innovation in Hepatology. 2023 Apr 26;5(8):100776. doi: 10.1016/j.jhepr.2023.100776. PMID: 37360567

Adherence to endoscopic surveillance for advanced lesions and colorectal cancer in inflammatory bowel disease: an AEG and GETECCU collaborative cohort study. Pilar Ballester M, Mesonero F, Florez-Diez P, Gomez C, Fuentes-Valenzuela E, Martin N, Senosiain C, Vela M, Fernandez-Clotet A, Perez P, Rubin de Celix C, Calvino-Suarez C, Hermida B, Munoz R, Gonzalez-Vivo M, Brunet E, Jimenez N, Botella B, Yebra J, Suarez-Ferrer C, Bouhmidi A, Lopez-Serrano A, Ponferrada A, Duenas C, Minguez M. Alimentary Pharmacology & Therapeutics. 2022 Jun;55(11):1402-1413. doi: 10.1111/apt.16832. PMID: 35224758

Automated whole-liver MRI segmentation to assess steatosis and iron quantification in chronic liver disease. Marti-Aguado D, Jimenez-Pastor A, Alberich-Bayarri A, Rodriguez-Ortega A, Alfaro-Cervello C, Mestre-Alagarda C, Bauza M, Gallen-Peris A, Valero-Perez E, Ballester MP, Gimeno-Torres M, Perez-Girbes A, Benlloch S, Perez-Rojas J, Puglia V, Ferrandez A, Aguilera V, Escudero-Garcia D, Serra MA, Marti-Bonmati L. Radiology. 2022 Feb;302(2):345-354. doi: 10.1148/radiol.2021211027. PMID: 34783592

Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy. Ballester M, Gallego J, Fiorillo A, Casanova-Ferrer F, Gimenez-Garzo C, Escudero-Garcia D, Tosca J, Rios M, Monton C, Durban L, Ballester J, Benlloch S, Urios A, San-Miguel T, Kosenko E, Serra M, Felipo V, Montoliu C. Scientific Reports. 2022 Feb 14;12(1):2463. doi: 10.1038/s41598-022-06416-z. PMID: 35165326

Minimal hepatic encephalopathy is associated to alterations in eye movements. Casanova-Ferrer F, Garcia-Cena CE, Gallego JJ, Fiorillo A, Urios A, Calvo-Cordoba A, Ballester MP, Rios MP, Durban L, Hidalgo MR, Garcia F, Felipo V, Montoliu C. Scientific Reports. 2022 Oct 7;12(1):16837. doi: 10.1038/s41598-022-21230-3. PMID: 36207472

Plasma ammonia levels predict hospitalisation with liver-related complications and mortality in clinically stable outpatients with cirrhosis. Tranah T, Ballester M, Carbonell-Asins J, Ampuero J, Alexandrino G, Caracostea A, Sanchez-Torrijos Y, Thomsen K, Kerbert A, Capilla-Lozano M, Romero-Gomez M, Escudero-Garcia D, Montoliu C, Jalan R, Shawcross D. Journal of Hepatology. 2022 Dec;77(6):1554-1563. doi: 10.1016/j.jhep.2022.07.014. PMID: 35872326

Plasma extracellular vesicles play a role in immune system modulation in minimal hepatic encephalopathy. Gallego J, Fiorillo A, Casanova-Ferrer F, Urios A, Ballester M, Durban L, Megias J, Rubio T, Cabrera-Pastor A, Escudero-Garcia D, Felipo V, Montoliu C. International Journal of Molecular Sciences. 2022 Oct 15;23(20):12335. doi: 10.3390/ijms232012335. PMID: 36293192

Thiopurine adherence: high prevalence with low impact in UC outcomes. Gomez-Medina C, Capilla-Lozano M, Ballester Ferre M, Marti-Aguado D, Crespo A, Bosca-Watts M, Navarro Cortes P, Anton R, Pascual Moreno I, Tosca Cuquerella J, Minguez Perez M. Revista Española de Enfermedades Digestivas. 2022 Feb;114(2):76-82. doi: 10.17235/reed.2021.7630/2020. PMID: 33733802

A new score unveils a high prevalence of mild cognitive impairment in patients with nonalcoholic fatty liver disease. Gimenez-Garzo C, Fiorillo A, Ballester-Ferre M, Gallego J, Casanova-Ferrer F, Urios A, Benlloch S, Marti-Aguado D, San-Miguel T, Tosca J, Rios M, Monton C, Durban L, Escudero-Garcia D, Aparicio L, Felipo V, Montoliu C. Journal of Clinical Medicine. 2021 Jun 25;10(13):2806. doi: 10.3390/jcm10132806. PMID: 34202269

Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function. Rega D, Aiko M, Penaranda N, Urios A, Gallego J, Gimenez-Garzo C, Casanova F, Fiorillo A, Cabrera-Pastor A, San-Miguel T, Ipiens C, Escudero-Garcia D, Tosca J, Monton C, Ballester M, Ballester J, Aparicio L, Rios M, Durban L, Mir A, Kosenko E, Cases P, Felipo V, Montoliu C. Journal of Clinical Medicine. 2021 Jan 11;10(2):E239. doi: 10.3390/jcm10020239. PMID: 33440769

Risk factors and management strategies associated with non-response to aminosalicylates for maintenance treatment in ulcerative colitis. Marti-Aguado D, Ballester M, Minguez M. Revista Espanola de Enfermedades Digestivas. 2021 Jun;113(6):447-453. doi: 10.17235/reed.2021.7797/2021. PMID: 33569968

Surgical treatment of an intraductal papillary mucinous neoplasm of the biliary tract diagnosed by SpyGlass®. Martí Fernandez R, Garces Albir M, Ballester Ferre M, Dorcaratto D, Villagrasa Manzano R, Muñoz Forner E, Gómez Adrián J, Sanchiz Soler V, Sabater Orti L, Ortega Serrano J. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva. 2021 Jan;113(1):45-47. doi: 10.17235/reed.2020.7122/2020. doi: 10.17235/reed.2020.7122/2020. PMID: 33054282

Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrosis. Ballester M, Lluch P, Gomez C, Capilla M, Tosca J, Marti-Aguado D, Guijarro J, Minguez M. Internal and Emergency Medicine. 2021 Sep;16(6):1519-1527. doi: 10.1007/s11739-020-02602-x. PMID: 33400160

+ Info
Title: Caracterización del deterioro neurológico y la respuesta al tratamiento con rifaximina en pacientes con encefalopatía hepática mínima
Doctoral candidate: Ballester Ferré, Maria Pilar
Director(s): Montoliu Félix, Carmina; Escudero García, Desamparados; Serra Desfílis Miguel Ángel
Date of the defense: 08/01/2021
University: Universitat de València