Liver Disease Strikes Children, Too
Cincinnati Children’s at the forefront of new treatments
A few decades ago, when William Balistreri, MD, pushed for more investigation into the causes of liver disease in children, few appreciated the implications of the research he was proposing. The idea that children developed cirrhosis — a condition most people linked to adults and alcohol — was diffi cult to comprehend.
Much has changed since then, says Dr. Balistreri, one of the foremost authorities on childhood liver disease and medical director of the Pediatric Liver Care Center at Cincinnati Children’s. He credits his team of researchers and clinicians for contributing to the deeper understanding that has changed the outcome for children with liver disease.
Clarifying the Causes
Investigators at Cincinnati Children’s have described a wide spectrum of causes of liver disease, including viruses and genetic disorders. With the recent epidemic of adolescent obesity, they are also exploring links between liver disease and obesity.
Their collaboration with other medical centers has allowed new studies related to genetic causes of liver disease and has been “very productive,” Dr. Balistreri says, because researchers have access to more cases to study.
In all, Pediatric Liver Care Center researchers participate in five multi-center programs sponsored by the National Institutes of Health.
Findings Guide New Treatments
A clearer understanding of where liver disease begins has enabled doctors to target its causes for more effective treatment.
“If the liver isn’t working to capacity, and the cause is a virus, we can try to eliminate the virus and let the liver heal,” Dr. Balistreri explains.
“If the cause is a problem with a child’s metabolism, we can attempt to correct it with drugs or develop a pathway to get around the blockage.”
The greatest advances in treatment of liver disease relate to metabolic or genetic causes, says Dr. Balistreri. “With the mapping of the human genome, we have the tools to identify genetic defects and to target genes.” This has led investigators at Cincinnati Children’s to new treatment strategies, including drugs that offer better quality of life.
A Vital Organ
Dr. Balistreri’s commitment to treating and curing liver disease is rooted in his appreciation for the organ that plays a vital role in sustaining life. The liver filters the body’s blood supply; cleanses it of harmful substances; makes protein so blood will clot; and processes nutrients.
When the liver is not functioning, often a child’s skin will look yellow, the condition known as jaundice. Other common symptoms of liver malfunction are fatigue, bleeding and poor growth.
Stay Alert to Symptoms
Although jaundice is common in newborns and may not be a problem, Dr. Balistreri says parents should alert their pediatricians if jaundice continues after two weeks of age, if the baby’s stools are consistently palecolored or if the urine is not clear.
“Parents need to be vigilant, especially if symptoms appear between well-baby visits,” he cautions. In Ohio, all newborns are screened for metabolic disorders that can lead to liver disease. “The screenings yield great benefi ts for uncovering liver diseases that would otherwise run their course with severe, devastating effects,” Dr. Balistreri says.
When early interventions fail, some children are candidates for liver transplantation. Many who have transplants suffer from biliary atresia, a deadly liver disease. Since 1985, surgeons at Cincinnati Children’s have transplanted healthy livers into 500 children.
Curing liver disease in children begins with vigilant parents and good communication between parents and pediatricians.
“Parents are the best judge of their child’s wellness,” Dr. Balistreri believes. “Don’t be afraid to bring your concerns to your doctor.”
Learn More
Find out more about the liver diseases we treat at Cincinnati Children's.
