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Hepatology

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Hepatology is the diagnosis and treatment of problems in the liver, gallbladder and bile ducts. Seattle Children’s has the only liver program in the Pacific Northwest especially for children. To make sure your child's care is complete, our hepatology team works closely with other Children's specialties, including pediatric surgery and genetics. We're part of the Northwest's only liver transplant team for children, and we run an active research program studying liver diseases in children.

Conditions We Treat


We diagnose and treat a wide variety of conditions that affect your child's liver, including:


Acute liver disease and acute liver failure

Many diseases, including hepatitis and autoimmune hepatitis, can affect your child’s liver. The liver can also be damaged by poisons, herbs and even some medicines — a condition called drug- or toxin-induced liver disease. Some short-term (acute) liver diseases can be treated. Others can cause the liver to stop working, which is called liver failure. When liver failure results from a sudden illness, it is called acute liver failure.  Liver Diseases, Liver Failure

Autoimmune hepatitis

Autoimmune hepatitis is a chronic disease of the liver which results from the patient’s own immune systems attacking the cells of the liver. The trigger for the immune attack is not well understood but there is an increased risk in families with other autoimmune diseases. The patient may present with a spectrum of disease from severe acute liver failure through a more insidious course ultimately where the disease is only revealed when significant chronic liver injury (cirrhosis) is present. Treatment is with corticosteroids and other immunomodulatory medications.

Cholestatic liver disease

Cholestasis means that the flow of bile is reduced or blocked. Bile is a fluid that helps with digestion. Several liver problems can scar the bile ducts or make them swollen, which can block bile. They include hepatitis and primary sclerosing cholangitis. Babies can be born with a number of conditions that may cause problems with the way bile moves. Three of these conditions are biliary atresia, progressive familial intrahepatic cholestasis (PFIC) and Alagille's syndrome.

Cirrhosis

Cirrhosis is severe scarring of the liver. In people with cirrhosis, scar tissue replaces healthy tissue over time. This causes less blood to flow through the liver and makes the liver unable to work as well. While many people think cirrhosis is caused by alcohol use, it can have other causes, such as hepatitis, fatty liver disease, diseases that damage or destroy the bile ducts and metabolic liver disease.

Cystic fibrosis–related liver disease

Cystic fibrosis is a condition that causes thick, sticky mucus to build up and clog some parts of the body. Most often, the mucus clogs the lungs and pancreas, but it can also affect the liver. When mucus clogs the liver, fluids are not able to flow as they should. This can cause scarring or swelling and affect the way the liver works.

Fatty liver disease

When people — children or adults — are overweight or obese, fat can build up in their livers. Sometimes, the buildup causes no problems. But having fat in the liver can cause lasting damage. Over time, fat in the liver can lead to swelling or scarring, and the liver may no longer work properly.

Gallstones, gall bladder disease and gall bladder ambulatory services

Gallstones are small, stone-like objects that form when the liquid in the gallbladder hardens. This liquid is called bile. It helps the body digest fats. The liver makes bile, and the gallbladder stores it until the body needs it. Read more.

Liver masses and tumors

There are several causes for masses in the liver, which may be derived from various cell types found in the liver, including liver cells, blood vessels and bile duct cells. Many of these masses are benign, i.e., not cancer. There are two main types of liver cancer in children.

Metabolic liver disease

Metabolic diseases affect the way your child’s cells break down or get rid of toxic substances in the body. Often, these diseases are passed down in a family. Several metabolic diseases affect the liver. A few examples are glycogen storage disease, Wilson disease and alpha 1 antitrypsin deficiency.

Portal hypertension

Portal hypertension is high blood pressure in the portal vein, which brings blood from the intestine to the liver. The high blood pressure occurs when the flow of blood through the liver is blocked. The condition can cause new veins to develop. These new veins can allow blood to circulate without going through the liver. When this happens, substances that are usually filtered out by the liver may move throughout your child’s bloodstream. The new veins also can cause bleeding into the stomach.

Primary sclerosing cholangitis (PSC)

PSC is a chronic liver disease caused by inflammation and scarring of the bile ducts of the liver. The underlying cause of the inflammation is thought to be autoimmunity. Many patients with PSC also have inflammatory bowel disease. Progression is usually slow but may lead to jaundice, itching and cirrhosis. There is no known cure and treatment is directed at symptoms.

Viral hepatitis

Hepatitis is a liver disease that is usually caused by virus. Hepatitis B and C are both caused by viruses that move from one person to another through blood or other body fluids. A woman with one of these viruses can give hepatitis B or C to her baby at birth. Both are serious infections, and can eventually lead to scarring of the liver or liver cancer.

Services We Provide


We offer services for the treatment and management of all liver diseases in children. Our services include:


Liver biopsy

During a liver biopsy, doctors take a small sample of the liver. Later, they examine the sample under a microscope to look for signs that help them make a diagnosis. All children receive sedation under control of a pediatric anesthesiologist for the biopsy.

Liver transplantation

Children's has the only programs in the Pacific Northwest for liver transplants and small bowel transplants for children. Read more.

Support for children with end-stage liver disease

We care for children whose livers can no longer perform their vital functions. Children who have end-stage liver disease may need a liver transplant for long-term survival.

Treatment of portal hypertension

High blood pressure in the veins in and around the liver may need medical, surgical or radiological treatment, in which our team is highly experienced. Seattle Children's is the only hospital in the Northwest that does TIPS for children. Read more.

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