Jan. 19, 2021
The Pediatric Liver Clinic at Mayo Clinic diagnoses and treats a wide variety of liver diseases and disorders. Conditions include but are not limited to acute liver failure, biliary atresia, metabolic liver disease, viral hepatitis, urea cycle defects, liver cancers, primary sclerosing cholangitis, fatty liver disease, Wilson's disease, portal hypertension, congenital hepatic fibrosis and Alagille syndrome.
Comprehensive team approach with evaluation and diagnostics
"Liver disease can impact physical and psychosocial development. Working with the referring physician is the cornerstone to achieving the best outcomes and overall coordination of care," says Sara Hassan, M.D., a pediatric transplant hepatologist at Mayo Clinic in Rochester, Minnesota. "Our pediatric transplant team provides an extensive evaluation to provide comprehensive assessment for liver disease and delivers exceptional care to the patient and family throughout the transplant journey."
The multidisciplinary team within Mayo Clinic Children's Center includes pediatric transplant hepatologists, dedicated transplant surgeons, infectious diseases experts, dietitians and physical therapists, transplant pharmacists, physician assistants and nurses, social workers, child life specialists, chaplains and financial coordinators.
Patients receive rigorous evaluation with laboratory testing and imaging — including magnetic resonance cholangiopancreatography, elastography, and other imaging techniques for vascular, biliary and tissue imaging — critical to the seamless coordination of services through a dedicated team to ensure a smooth transplant itinerary.
Liver biopsies are performed under anesthesia by interventional radiologists with ultrasound guidance to assure comfort and safety and analyzed by pathologists with specific hepatobiliary expertise. "We have partnered with a superb team of interventional radiologists, who provide a timely diagnosis of biliary diseases including biliary atresia, and assist in addressing any biliary or vascular issues that arise post-transplant with a minimally invasive approach," says Dr. Hassan. "Mayo Clinic's pediatric liver transplant program has dedicated surgeons who have expertise in deceased- and living-donor liver transplants in addition to extensive experience with liver and kidney transplant for oxalosis and polycystic kidney disease."
Immediately following liver transplantation and after hospital discharge, families are asked to stay local for frequent clinic visit appointments during which the team assesses the overall liver health, checks for medication side effects, monitors for recovery and watches for any signs of rejection. Following recovery and discharge, the transplant team works closely with the primary care providers to coordinate care once the patient is back at home. "For long-term monitoring, we work closely with the referring physician and our adult colleagues to help transition young adult patients to adult hepatologists with expertise in congenital liver disease and post-transplantation care," said Dr. Hassan.
Research and advanced technology
To improve diagnosis and treatment techniques, Mayo Clinic has a history of leading efforts in basic and translational research studies in pediatric liver diseases and transplant.
Mayo Clinic provides innovative transplant surgeries including deceased donor, living donor and combined organ transplantation. State-of-the-art care is deployed to ensure adequate liver health both pre- and postoperatively. This care includes the use of molecular adsorbent recirculating system therapy, which removes albumin-bound toxins from the blood and single-pass albumin dialysis, among others.
"Our special interest in primary sclerosing cholangitis, autoimmune liver disease and liver neoplasia follows the long tradition of expertise in these disorders at Mayo Clinic, which has the largest pediatric cohort study of these patients in the country," says Dr. Hassan. "In addition, given our expertise in metabolic liver disease, we offer liver transplant for glycogen storage disease, tyrosinemia, congenital disorders of glycosylation and urea cycle defects. These patients benefit from well-coordinated peritransplant care in collaboration with the genetic and metabolic specialists."
For more information
Mayo Clinic Children's Center: Pediatric Liver Clinic. Mayo Clinic.
Mayo Clinic Children's Center. Mayo Clinic.
Liver Transplant Program. Mayo Clinic.