At Seattle Children’s, the Pacific Northwest’s only dedicated pediatric hepatologists are actively engaged in research consortiums and working to improve treatments for pediatric liver diseases.

 Two of these physicians, Dr. Evelyn K. Hsu, program director of the Advanced/Transplant Hepatology Fellowship at UW Medicine and Seattle Children’s, and Dr. Karen F. Murray, chief of the Division of Gastroenterology and Hepatology at Seattle Children’s and vice chair of clinical affairs for the Department of Pediatrics at UW Medicine, have spearheaded a number of innovative studies that have improved children’s access to lifesaving transplants and medications.

Researching – and changing – the algorithms of organ allocation

“In the world of liver transplantation, we simply do not have enough organ donors to meet the demand,” Hsu says. “Difficult decisions need to be made about who will receive a lifesaving liver.”

To better understand how these decisions directly affect children who need transplants, Hsu recently led a retrospective cohort study of children on the United States liver transplant waiting list from 2007 through 2014. The study revealed that under the current system of organ allocation, an estimated 45% of children who were taken off the transplant list because they were too ill or had died had never been offered a transplant.

“It is up to policymakers to use this information to adjust the allocation algorithm so that this does not occur,” Hsu says. “We will continue to do the research necessary to show what is happening to these children and fight for change.”

‘Changing the face of hepatitis C treatments’

Murray has been involved in viral hepatitis research for 20 years and most recently led clinical trials of the hepatitis C medication ledipasvir/sofosbuvir (Harvoni). Her efforts have given children a game-changing alternative to interferon, which requires six to 12 months of treatment and comes with numerous side effects.

“Harvoni is an oral medication with little to no side effects, and the success rates are far better than any treatment that has been available before,” Murray says. “It’s become the standard of care in adults now, and it should be for kids, as well.”

As the study’s principal investigator and the site principal investigator of Harvoni trials at Seattle Children’s, she helped lead 10 U.S. medical experts in a trial of the drug in children ages 12 to 17 that ultimately led the U.S. Food and Drug Administration to approve Harvoni for that age group. Another trial for Harvoni’s effectiveness in children ages 6 to 11 just completed enrollment, and subjects down to age 3 are currently being enrolled in still another trial.

Improving care for children with hepatitis C is crucial, Murray says, not only to find a cure and prevent the associated liver disease but also to improve their quality of life and functioning.

“In addition to causing liver disease, we now know that hepatitis C has a negative impact on executive functioning, both in adults as well as kids. Furthermore, there’s the psychosocial piece,” she says, referring to the stigma associated with the disease and the negative social impact infected individuals can experience.

“These trials are really exciting because they’re changing the face of hepatitis C treatments for pediatrics,” Murray said.

Call 206-987-7777 for provider-to-provider patient consults, and visit the Gastroenterology and Hepatology page to learn more.

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