The pediatric liver transplant program team includes, from left, Beau Kelly, M.D., Lynette Gillis, M.D., Carly Bhave, nurse practitioner, and Donna Williams, R.N. (photo by Kats Barry)
Liver transplant program dedicated to children debuts
The Monroe Carell Jr. Children's Hospital at Vanderbilt has launched the region's first Pediatric Liver Transplantation Program.
While older children, mostly teenagers, have been receiving liver transplants through the adult liver transplant program at Vanderbilt and similar programs across the region, the new Pediatric Liver Transplantation Program is the first to specialize in infants and children.
“Last year we had 600 visits for liver disease in children from newborns up to 18 years old,” said Lynette Gillis, M.D., medical director of the Pediatric Hepatology and Liver Transplant Program. “This year we are on target to see 700, so our medical program is large and has seen significant growth.”
Burnett “Beau” Kelly Jr., M.D., assistant professor of Hepatobiliary Surgery and Liver Transplantation, serves as surgical director.
The United Network for Organ Sharing (UNOS) matches donors with recipients. Vanderbilt is part of an “administrative region” that includes Tennessee, Kentucky, North and South Carolina and Virginia, but Kelly says livers can be brought in from almost anywhere if they are a good match.
“We can go anywhere in the country, if the quality of the organ is appropriate and matches the needs of the patient,” Kelly said. “The need is definitely there, so part of our mission will also be education about organ transplantation.”
Brent Polk, M.D., interim chair of Pediatrics, medical director and physician-in-chief of Children's Hospital, said the new program will enhance patient care.
“Adding the transplant surgery will now permit our patients, their families and friends to remain in the same supportive environment as they await and receive their transplants. I am proud to be a small part of this exciting advance in our department and hospital,” Polk said.
“This program will enable Middle Tennessee children with liver disease to receive world-class care right here in their backyard,” said Ravi Chari, M.D., chief of the Division of Hepatobiliary Surgery and Liver Transplantation.
“For families, it will alleviate the burden of travel. We have two excellent stewards and leaders of the program in Drs. Beau Kelly and Lynette Gillis. Transplantation truly demands 'team medicine' and that demand plays to their, and Children's Hospital's, strengths.”
“This is a natural progression from our excellent adult liver transplant program, and a goal of Children's Hospital is to offer all pediatric services,” said John Brock III, M.D., surgeon-in-chief of Children's Hospital.
“For our pediatric population, liver is one of the major solid-organ transplants, and the need is significant in this region. The pediatric population is different from the adult population, with a different set of reasons for transplantation.”
The most common reason children need transplantation is a birth defect called biliary atresia — progressive inflammation resulting in blockage of the bile ducts and subsequent jaundice and end-stage liver disease. The rest of the potential candidates for transplantation suffer cirrhosis for a variety of reasons, including autoimmune disorders, tumors and various metabolic diseases. Occasionally, a previously healthy child develops acute liver failure, sometimes for unknown reasons.