Liver Care

Rapid, Accurate and Responsive Diagnosis and Treatment

Inside the Liver Center

Meet Dr. Alexander Weymann, Director of the Liver Center at Nationwide Children's

Liver Care (Hepatology) at Nationwide Children's

Nationally ranked for our expertise in Gastroenterology and GI Surgery and continuously recognized on the Honor Roll of the 10 Best Children’s Hospitals in the country, Nationwide Children’s sets the standard for exemplary patient care from the first contact with your child through their course of an illness, until the best possible outcomes are achieved. Our comprehensive liver care team treats all liver and bile duct diseases, utilizing all available medical treatments. When indicated, any necessary surgical procedures, including liver transplant, are offered.

Navigating the complex landscape of care when your child has liver disease can be scary. Our experienced team of hepatology physicians, hepatopancreatobiliary surgeons, nurse practitioners, nurses, social workers, pharmacists and dietitians has extensive experience helping families with all aspects of caring for a child with liver disease and related conditions. We are ready to support your child’s medical needs while assisting with emotional support and managing the financial impact of their care.

 
US News Badge Gastroenterology

Nationwide Children's Hospital is ranked by U.S. News & World Report for Gastroenterology and GI Surgery.

Your Continuum of Care

As your child changes and grows, so do their liver care needs. At each stage of growth, we create a treatment plan that maximizes health and makes sense for real life. The liver care team will provide a smooth continuum of care for your child. We will ensure that transitions from inpatient to outpatient settings are managed transparently and efficiently, ensuring the best possible outcomes. When the time comes, your child’s transition from pediatric to adult care will be held to the same high standard.

Exceptional Care. Everywhere.

Our Liver Care team offers care for all children with liver disease. Everywhere in our system, your child’s liver care team will include:

  • Hepatology: A highly trained pediatrician who focuses on medical care for children with liver disease.
  • Liver surgeons: Our surgeons have each completed fellowships in pediatric and transplant surgery, making them uniquely qualified to perform any procedure your child may need, providing a continuum of care that is not possible in every pediatric transplant center.
  • Advanced practice nurse practitioners: Our nurse practitioners are highly skilled clinicians who will help direct and carry out complex care plans.
  • Social work: Our social workers are focused entirely on pediatric liver care, making them familiar with the complex needs your child may have.
  • Financial and care coordination: Our nurse coordinators will work with you throughout your child’s time, ensuring seamless transitions and making sure your child’s needs are met.
  • Dietitians: The nutritional needs of children with liver disease can be complex and require a personalized, nuanced plan. Our nutritionists are equipped to evaluate your child and ensure their nutritional needs are met.
  • Other medical specialists as needed: Sometimes consultations with other medical specialists are required. Consultation with any pediatric subspecialty expert is available as needed.

Outpatient Clinic

In our outpatient clinic, you will encounter a multidisciplinary team of highly trained medical professionals. Every child will receive a personalized care plan to meet all their needs.

  • Inpatient Services: We offer full-service inpatient care and routinely manage patients in the Pediatric and Neonatal Intensive Care Units, as well as inpatient wards for liver conditions. As patients undergo monitoring, testing and surgery preparation or recovery, our team works together to keep your child comfortable, and you informed.
  • Liver Transplantation: As a United Network for Organ Sharing (UNOS)-accredited transplant program, Nationwide Children’s partners with hospitals in Ohio and beyond to provide a seamless transplant experience. We are dedicated to achieving the best possible outcomes for every child requiring liver transplantation.
  • Neonatal Intensive Care Unit (NICU): A unique component of the Nationwide Children’s liver care program is that continuity of care is the standard of care. One doctor is assigned to your child’s care throughout his or her stay in the NICU. When your baby is healthy enough to be discharged, that same doctor will provide follow-up any needed follow-up care in clinic.
  • Center for Healthy Weight and Nutrition: One of the most common liver problems we treat is Non-Alcoholic Fatty Liver Disease (NAFLD). If NAFLD is not diagnosed and treated promptly, it can lead to permanent liver scarring, with an eventual need for a liver transplant. Our liver care team works closely with physicians, nurses, dietitians, exercise specialists, psychologists and social workers in the Center for Healthy Weight and Nutrition to monitor and manage fatty liver disease as children undergo weight reduction treatments. Treatments include nutritional and behavioral interventions, tailored exercise programs and surgery.

Conditions and Care

Our Liver Care team evaluates and treats children for any liver-related abnormality found on physical examination, blood testing (elevated liver enzymes) or imaging.

We also offer the most advanced and state-of-the-art surgical expertise in liver transplantation and abdominal surgery, as well as experience with a large volume of post-NICU liver disease patients. We routinely manage liver care for children pre- and post-transplantation, including many patients transplanted at other centers. At all phases of transplant care, we consider your child’s specific needs. Whether this is when adjusting medications, providing pain relief, developing care plans, preparing for the transplant event, post-transplant care or discharging to home, our team will provide a dedicated focus to your child’s treatment.

Conditions We Treat

From newborns to young adults ready to transition to adult care, we offer comprehensive evaluation and treatment for all liver conditions. Our experts have experience in even the most rare and complex liver problems. We will provide a personalized care plan that meets all your child’s needs.

Newborn and Infant Liver Diseases

  • Alagille syndrome
  • Alpha-1 antitrypsin deficiency
  • Biliary atresia
  • Choledochal cyst
  • CMV hepatitis
  • Cystic fibrosis
  • Idiopathic neonatal/infantile hepatitis
  • Jaundice in infants
  • Liver disease of prematurity
  • Other genetic liver diseases (progressive familial intrahepatic cholestasis, bile acid synthesis defect, peroxisomal disorder, mitochondrial hepatopathy, etc.)

Childhood and Teen Liver Diseases

Diseases Causing Enlarged Liver or Spleen

  • Cirrhosis with portal hypertension
  • Congenital hepatic fibrosis
  • Congestive hepatopathy
  • Extrahepatic portal vein thrombosis
  • Hepatic adenoma
  • Hepatoblastoma
  • Hepatocellular carcinoma
  • Non-cirrhotic portal hypertension
  • Storage diseases

Diseases Found on Imaging Tests

  • Bile duct strictures
  • Choledochal cyst
  • Fatty liver
  • Focal nodular hyperplasia
  • Gallstones
  • Hepatic adenoma
  • Liver cyst
  • Liver hemangioma
  • Liver tumors, including hepatoblastoma and hepatocellular carcinoma
  • Portosystemic shunts

Diseases Causing Acute Hepatitis or Liver Failure

  • Drug toxicity (such as from erythromycin, valproic acid or an overdose of acetaminophen)
  • Immune-mediated hepatitis
  • Metabolic diseases
  • Viral hepatitis
  • Wilson disease

Diagnosis

Liver conditions are often diagnosed based on a combination of liver-related blood tests, imaging and patient symptoms. In some cases, your child may require a liver biopsy. These tests help the care team understand how well the liver is working, what type of damage may be present and establish a diagnosis. Blood tests can also be used to screen for genetic diseases.

Imaging options for evaluation of a liver condition may include:

Endoscopic diagnostic tools:

  • ERCP (endoscopic retrograde cholangiopancreatography)
  • EUS (endoscopic ultrasound), including biopsy and portal pressure gradient measurements
  • Diagnostic endoscopy

Treatment

Treatment for your child will be tailored to their diagnosis and focused on achieving their optimal outcome. Your child’s liver care team will work with your family to ensure your understanding of the diagnosis and its possible impact on your child. We will also establish a comprehensive treatment plan that maximizes your child’s chance of a healthy and normal life.

We offer many special clinics and expert care programs for children visiting Nationwide Children’s, including:

  • General Hepatology (Liver Care) Clinic
  • Multidisciplinary Fatty Liver Disease Clinic
  • Specialty care teams for patients with liver disease caused by cystic fibrosis, congenital heart disease or complex problems related to prematurity

Advanced Intervention

In some cases, liver problems may require interventional radiology, advanced endoscopy, surgery or even a transplant. Our program has world-class imaging capabilities and some of the country’s most skilled pediatric interventional radiologists. We offer endoscopy procedures that minimize procedure-related risk and speed recovery time for gastroesophageal varices and hemorrhage.

When a liver transplant is required, we will evaluate your child to ensure their readiness for transplant. We will carefully explain the listing process and the donor selection process. We will perform the transplant operation and provide multidisciplinary pre- and post-transplant care. Our team includes some of the most experienced and dedicated pediatric liver transplant surgeons in the country.

Advanced operations we perform:

  • A highly specialized surgical team with extensive experience in hepatoportoenterostomy (Kasai procedure) for biliary atresia, choledochal cyst resection and complex resections of tumors and masses
  • The most state-of-the-art surgical capabilities, including technical variant grafts (reduced-size grafts, split-liver grafts and living donor transplantation. This will help minimize your child’s time on the wait list.
  • Liver transplantation in the smallest infants (less than 12 months of age)
  • Expertise in portal hypertension operations, including meso-Rex shunts for extrahepatic portal vein thrombosis, distal splenorenal shunts and mesocaval shunts
  • Internal and external biliary diversions
  • Autologous intestinal reconstruction surgery, including the Bianchi procedure and the serial transverse enteroplasty (STEP) procedure, for children with intestinal failure

Our Multidisciplinary Liver Care Team

The liver care specialists at Nationwide Children’s include our expert team of physicians, surgeons and other medical professionals. Collectively the team shares in-depth knowledge and experience helping families navigate the practical, emotional and financial aspects of caring for a child with liver disease and related conditions – including pre- and post-liver transplant care.

Our dedicated care team includes members from:

Meet Our Liver Center Team

Liver Care Research

The hepatology physicians and surgeons at Nationwide Children’s collaborate with other medical professionals and scientists around the nation to develop new treatments for liver diseases, to improve quality of life and raise the standards of care for all children with liver disease.

We conduct clinical research in hepatobiliary surgery, liver transplantation, autoimmune hepatitis, primary sclerosing cholangitis, neonatal cholestasis, genetic liver disease, pediatric portal hypertension and more. We constantly strive to improve patient outcomes while delivering the best quality of care. We also work to advance surgical and medical options for children with liver disease.

Learn more about current research studies or participate in a clinical trial.

 

View Open Clinical Trials

Family Resources

We have comprehensive Family Support Services for all patient families seeking care at Nationwide Children’s. For patients traveling internationally to obtain care with our experts, we also offer our Global Patient Services. These programs simplify and streamline your experience, from financial arrangements to travel logistics. Our full range of support services include language interpretation, lodging, care coordination, communication with referring physician teams, care transition planning and assistance with childcare for traveling siblings.

If you wish to know more about your child’s condition or what to expect during your visit, please speak with your child’s doctor or read more about liver-related care, diagnoses and treatments on our website.

Many general liver and diagnosis-specific support organizations also exist, including:

General

Transplant

Disease-specific

Liver Transplant Program

Nationwide Children’s is a United Network for Organ Sharing (UNOS)-accredited and CMS (Center for Medicare and Medicaid Services)-approved transplant center with unsurpassed experience and the nation’s top pediatric liver transplant professionals. Our multidisciplinary medical and surgical liver care team provides care for transplant candidates from the very first evaluation to the time they head home — and beyond.

Our expert surgical team uses the most advanced procedures and technology to care for children of all ages, beginning in infancy and extending into young adulthood. We offer all technical variant grafts in liver transplantation, including split liver grafts, reduced-sized grafts and living donor transplants, to optimize outcomes and reduce time on the waiting list.

Learn More About Liver Transplant