Treatments and Services
What is the Hepatology Program?
Hepatology is the study and treatment of liver diseases. Seattle Children’s is home to the only liver (hepatology) and liver transplant programs for children in the Pacific Northwest. Hepatology Program doctors diagnose and treat the full range of liver diseases in children ages birth to 21. Our doctors are also members of the liver transplant team, so children who ultimately need transplant surgery will have a care team made up of familiar faces.
A healthy liver breaks down and stores (metabolizes) substances the body takes in from food. (Learn more about how the liver works.) This means children with liver disease might not get proper nutrition. This can lead to them growing and developing slower than other kids. We have expertise working with young patients to address all the ways liver disease can affect them.
We treat both acute and chronic liver failure and offer same- or next-day appointments for urgent cases. Acute liver failure occurs after a sudden illness in a child who has no history of liver disease. Chronic liver failure occurs at the end of a long-standing liver disease. This is sometimes called end-stage liver disease.
What’s special about the Hepatology Program at Seattle Children’s?
We care for liver patients every day. We have experience treating all liver conditions with the most state-of-the-art medical therapies and surgical techniques. In 2018, U.S. News & World Report ranked Seattle Children’s the #1 pediatric gastroenterology program in the Northwest – and one of the best in the nation. Every day we strive to improve the care that is available to children. Through our dedication to clinical research, we hope to be able to prevent or change the course of pediatric liver disease in the future.
Our team will work with you to create the treatment plan that will best meet your child’s needs. All care providers work off this same care plan and will sit down with you and your child to discuss the plan and answer your questions. On your first visit with the Hepatology Program team, you and your child see a doctor and a nurse. A social worker and registered dietician are here for consultation if needed.
Throughout their treatment and clinic visits, most children will see all the doctors in the Hepatology Program. We believe that this approach, rather than seeing the same doctor every time, is a real benefit to children with chronic disease. Your child gets the attention and knowledge of many experts, and each doctor on the team gets to know your child and understand their history and challenges. Any one of us can answer your questions and help you evaluate options at any point during your child’s care.
Doctors in the Hepatology Program also work closely with these teams:
- Advanced Endoscopy
- Biochemical Genetics
- Interventional Radiology
- Psychiatry and Behavioral Medicine
- Pediatric surgeons and anesthesiologists
- Transplant Center
- Transplant Surgery
These partnerships help us make complex diagnoses and devise and carry out complex care. We make recommendations for other caregivers when needed and help you coordinate your appointments.
Our Hepatology Program team members are also on the liver transplant team. Dr. Simon Horslen, who is an internationally recognized children’s liver specialist, is the medical director of Solid Organ Transplantation. Dr. Evelyn Hsu is the medical director of our Liver Transplant Program. If your child has serious liver disease and transplantation is being discussed, the Hepatology team can answer questions you have about what happens next and what to expect. If your child requires a liver transplant, many of the same caregivers will follow them through the transplant process. Children who receive liver transplants at Seattle Children’s have some of the best outcomes in the nation.
At Seattle Children’s we treat your whole child, not just their symptoms. We understand that being sick is hard on kids and their families. Members of our care team include child life specialists, psychologists and social workers who care for the mental and emotional health of you, your child and family. We welcome your questions and concerns about how your child’s illness, medicines or surgery will affect their quality of life.
Our program has a strong focus on nutrition. Unlike most adults with liver disease, many of the children we see have liver problems that they were born with or that started at a very early age. Because the liver breaks down nutrients, kids with liver disease often have trouble growing. Our nutritionists work with you and your family to make sure that your child receives the proper nutrients to let them grow and have energy to do the things they love to do. We are here to support you, from finding foods your child can tolerate to working with home care to provide food supplements or nutrition for a child on total parenteral nutrition (TPN).
We care for patients from a large region that includes the Pacific Northwest, Idaho, Alaska, Hawaii, Montana and Wyoming. We want to deliver the best care in a way that families can manage. We know that travelling to Seattle Children’s main campus is not always feasible. In these cases, we often practice “shared care.” In shared care, your child’s treatment is directed by our team, but some appointments are at one of Seattle Children’s outreach clinics or the office of another gastroenterologist near you.
For those families that do need to travel long distances, our social workers and Guest Services can help find hotels or other places to stay. Read more about options such as hotels, RV parks and Ronald McDonald House.
We are actively researching and developing new treatments for liver disease in children. We’re able to offer many treatments that are available only through clinical studies. This means our patients have access to some of the most current, state-of-the-art therapies. We are currently participating in research aimed at improving care for children with the following conditions:
- Acute liver failure
- Cholestatic liver disease
- Liver transplantation
- Metabolic liver disease
- NASH/fatty liver disease
- Viral hepatitis
- Liver transplantation
Many drug treatments for liver disease that are approved by the U.S. Food and Drug Administration (FDA) for adults aren’t approved for children. We participate in clinical trials to bring these treatments to children:
- The drug combination ledipasvir/sofosbuvir (Harvoni) was previously approved for hepatitis C treatment only for adults. In one recent clinical trial of the drug formula, teens with hepatitis C were treated successfully. This success influenced the FDA’s recent approval of Harvoni for children ages 12 to 17. Read about one Seattle Children’s patient who had life-changing results by participating in this study.
- In an ongoing clinical trial, we are able to provide Harvoni to hepatitis C patients as young as age 3. Traditional hepatitis treatment uses injections, but Harvoni can be given by mouth. This makes it a much easier treatment for young children to tolerate.
- We are also able to make Fibroscan, a noninvasive imaging study used for liver biopsies, available to children as part of our research. This biopsy technique is not otherwise available to children.
Conditions We Treat
We treat the whole range of liver diseases, including:
- Acute hepatitis and acute liver failure. (Learn about liver diseases and liver failure.)
- Alagille syndrome (ALGS)
- Alpha-1-AT deficiency
- Autoimmune hepatitis
- Biliary atresia
- Cholestatic liver disease
- Choledochal cyst
- Cystic fibrosis–related liver disease
- Failure to gain weight (failure to thrive). (Learn about failure to thrive.)
- Fatty liver disease
- Hepatitis B and C (viral hepatitis)
- Liver failure
- Liver masses and tumors
- Metabolic liver disease
- Portal hypertension
- Primary sclerosing cholangitis (PSC)
- Progressive familial intrahepatic cholestasis (PFIC)
Scheduling an appointment with the Hepatology Program
- To make an appointment with the Seattle Children’s Hepatology Program, you need a referral from your primary care doctor or specialist.
- Get more information about how to schedule an appointment at Seattle Children’s.
- See our Insurance Services page for answers to your questions about insurance coverage.
- If you already have an appointment, learn how to prepare.
- Learn about Hepatology Program resources such as useful links, videos and recommended reading for you and your family.
Refer a patient
We’re committed to partnering with referring providers and answering their questions. If you are a referring physician and would like to talk to a Hepatology Program physician about a patient, call 206-987-7777.
Read about how to refer a patient.
Who’s on the team?
- Simon Horslen, MB ChB, medical director, Solid Organ Transplantation; director, Hepatobiliary Program
- Evelyn Hsu, MD, medical director, Liver Transplant Program; director, Hepatology Fellowship Program
- Karen F. Murray, MD, division chief, Pediatric Gastroenterology and Hepatology
- Niviann Blondet, MD
Advanced registered nurse practitioner
- Natalie Donahue, RN
- Melissa Mortensen, MS, RD, CSP, CD
Hepatology research coordinators
- Kara Cooper
- Stephanie Lammers
- Melissa Young
- Danny Gagucas
- Natalie Lang
- Tiffany Martin