Departments

The Pediatric Liver Transplant program at Yale New Haven Transplantation Center is the only transplant center offering pediatric liver transplantation in Connecticut, Rhode Island, Vermont, and southern Massachusetts. We are known nationally and internationally for our success in treating the full spectrum of liver problems in children. Our team has a combined experience of more than three decades, and our outcomes, both in terms of complication rates and long-term survival, are among the best in the nation. We are committed to a family-centered care philosophy in which we partner with the whole family to treat the child, not just the disease.

A variety of diseases can affect the health of the kidneys. We care for patients at every stage of kidney disease, offering scientifically proven treatments and a personalized care plan. The Department of Urology is part of the Living Donor Transplant Program at the Yale New Haven Transplantation Center where we care for patients with renal disease who are candidates for kidney transplantation. We have expertise in performing laparoscopic, living-donor nephrectomies, delivering the highest quality care to the kidney donor-patient team at Yale. At Yale Medicine, our patients have full access to leading physicians who can help with all aspects of renal disease. Patients also have access to world-class resources at Smilow Cancer Hospital at Yale New Haven. Our doctors are at the forefront of kidney disease and kidney cancer treatment and research, including novel immunotherapy approaches and the genetic characterization of kidney cancers. In addition, the Yale School of Medicine's Hereditary Kidney Cancer and Genetic Assessment Program investigates potential genetic causes of kidney cancer in young patients, including those with a family history and individuals with multiple tumors, to help family members determine if they carry a risk for kidney cancer.

Our uncompromising faculty and staff are dedicated to the welfare of children and adolescents. One of two major pediatric centers in Connecticut, Yale offers an extensive range of services for patients through our 14 specialties. In addition, we have several interdisciplinary centers and programs that involve collaborations with multiple departments throughout Yale Medicine and Yale New Haven Children’s Hospital. Thanks to our reputation for comprehensive pediatric care, we serve as a regional and national center for referral and consultation. Many of our physicians are internationally recognized for their innovative approaches to the diagnosis and treatment of conditions including arrhythmias, diabetes, cystic fibrosis, childhood cancers, juvenile diabetes, dyslexia, blood disorders, infectious diseases, and complications of premature birth, as well as many other disorders. We are leaders in the global pediatric community, advocates for childhood health and development, and innovators in research. We rank among the top pediatric centers in the country with respect to National Institutes of Health support for research. Neonatal and pediatric ICUs that serve our most vulnerable patients with the highest level of care 24/7 subspecialty telephone consultation service for primary care clinicians with expected response time of three minutes More than 20 years of experience with neonatal and pediatric Extracorporeal Membrane Oxygenation, a sophisticated machine that acts as an artificial heart and lungs, crucial for some seriously ill infants One-call center that provides centralized appointment scheduling for all pediatric specialties Close collaboration with other Yale departments to provide such services as molecular and genetic diagnostic services, state-of-the art management of high-risk fetuses and newborns, bone marrow transplantation, and management of complex malignancies

Pediatric surgeons dedicate their practice to treating children ranging from the neonatal stage through late adolescence. The medical needs of a child differ from those of an adult, requiring pediatric surgeons to have additional education and advanced training. Our pediatric surgeons are recognized as experts in a broad range of specialties, including minimally invasive surgery, pediatric surgical oncology, fetal diagnosis, and treatment of congenital birth defects, pediatric trauma, and surgical procedures for intestinal failure. Through the most current and state-of-the-art surgical techniques, we help treat each child’s condition so he or she can focus on being a kid.Our team has expertise in the latest surgical technologies and the most delicate surgical situations, including neonatal surgery and ECMO (heart and lung bypass for severely ill infants). Our surgeons use advanced, minimally invasive surgical techniques wherever possible to help secure outpatient surgeries or shorter hospital stays, and less postoperative discomfort for the child. All of our team members have extensive experience in working with children, and take extra measures to ensure that each child feels safe and comfortable. Specialized care is offered in the following areas: Mechanical cardiac assist device program Newborn surgery, including repair of severe newborn congenital malformations of the airway, respiratory, gastrointestinal, and genital tracts Operations for inguinal hernias, hydroceles, correction of undescended testicles, and other groin problems Pediatric abdominal surgery Pediatric heart transplant Pediatric thoracic surgery Surgical management of complex solid tumors Thoracoscopic and laparoscopic treatment of such conditions as abdominal and thoracic tumors, congenital lung masses, intestinal atresia, and trachea-esophageal fistula The first pediatric Level I trauma center in Connecticut at Yale New Haven Hospital Six conveniently located outpatient pediatric centers across the state where patients can be evaluated by a pediatric surgeon International recognition for new ways to reduce anxiety and pain in children who need surgery

Our multidisciplinary group of physicians and health providers are committed to providing state-of-the-art therapy to our patients with hepatitis B and hepatitis C infections. We have a 50-year tradition of excellence in liver research and patient care, and continue to be international leaders on the study and treatment of liver disorders. As a partner of the Yale School of Medicine Liver Center, one of only four liver research centers in the country sponsored by the National Institutes of Health, ours is the premier program in Connecticut offering comprehensive patient care for individuals with viral hepatitis. The key to effective disease management of acute and chronic viral hepatitis is our coordinated care among specially trained physicians, as well as a specialized nurse who provides teaching and psychological support. We enjoy close relationships with specialists in adult and pediatric gastroenterology, transplant hepatology, medical and transplant nephrology, transplant surgery, gastrointestinal pathology, diagnostic and interventional radiology, gastrointestinal surgery, rheumatology, OB/GYN, medical and surgical oncology, infectious diseases, the AIDS Care Program, psychiatry, and addiction medicine. The Gastrointestinal Pathology program at Yale is the only subspecialty program of its kind in Connecticut, and provides expert consultative services for the most challenging liver pathology examinations in the region. We partner with Yale New Haven Hospital’s Nathan Smith Clinic in the management of patients with HBV/HIV and HCV/HIV co-infections, and with the Yale Liver Transplant Program in the pre- and post-transplant evaluation and management of patients with liver cirrhosis and end-stage liver disease. We have four areas aimed at improving treatment and outcomes for viral hepatitis: Education: Providing formal education classes and individualized instruction sessions for patients with chronic hepatitis C infection prior to the initiation of antiviral therapy Treatment: Maintaining high standards of practice in treatment protocols and close coordination of care with referring physicians to provide the most advanced and scientifically based approaches to the management of viral hepatitis Research: Ensuring the opportunity for patient access to novel approaches in the treatment of viral hepatitis and liver disorders through clinical trials Community outreach: Building relationships with the surrounding communities of Greater New Haven and Connecticut to raise awareness about viral hepatitis, and to promote screening and education Special services offered by the Yale Viral Hepatitis Program include: Weekly multidisciplinary patient care conferences and liver pathology conferences to draw upon the varied expertise of our Yale Medicine physicians Coordination with the liver and kidney transplant programs Comprehensive services for diagnostic and interventional GI endoscopy, percutaneous and trans-jugular liver biopsy, paracentesis and trans

Our program strives to provide optimal access to kidney transplants to individuals for whom this is the best option. We work in coordination with the Yale New Haven Hospital Transplantation Program, which has clinical facilities in New Haven and at Saint Francis Hospital in Hartford, providing easy access to care for patients in Connecticut and western Massachusetts. Our dedicated providers offer direct care and support to patients and donors throughout the pre- and post-transplant periods. We also provide a full range of nephrology consultation services for patients with other organ transplants including heart, liver, and bone marrow. For our patients, we are able to: Expedite donor and recipient evaluation for patients not yet on dialysis. Perform internal exchanges and participate in two national exchange programs for recipients with medically suitable donors willing to consider this option. Schedule a first visit within four weeks of initial referral. Advocate for patients who have exhausted dialysis access to receive emergency transplant listing status. Provide a medical home for our patients with open access to our clinic on an urgent basis.

At Yale Medicine, our experts and caregivers give comprehensive and compassionate treatment for those with end-stage liver, kidney, and pancreas organ failure who might benefit from transplantation. We offer many treatment options and hope for high-risk patients who may have been turned down for transplant elsewhere, in addition full support services. Our expert physicians specialize in anesthesiology, internal medicine, pediatrics, surgery, transplant immunology, kidney diseases, liver diseases, diabetes mellitus, and transplant surgery. Our caring, highly skilled nurses, physician assistants, nutritionists, pharmacists, social workers, and financial counselors further support your needs. Many inherited metabolic liver diseases such as Wilson's disease, Gaucher's disease, lipidosis, alpha-1 antitrypsin deficiency, hemochromatosis, tyrosinemia, and glycogen storage diseases are cured by successful liver transplantation. We specialize in genetic testing for liver diseases and treatments that provide comprehensive care for affected patients. Even though we treat some of the most seriously ill patients, our program's survival rates are consistently higher than the national average. We offer many options for advanced liver disease, including living donor and deceased donor transplantation, liver transplantation in HIV-infected individuals, and pre- and post-transplant antiviral therapy to prevent or treat recurrent hepatitis C. Through our acute liver failure program, we can transfer patients to Yale New Haven Hospital in a timely manner for transplant evaluation and medical management. In collaboration with the hospital’s Medical Intensive Care Unit, we offer innovative techniques such as hypothermia therapy for the treatment of acute liver failure. Pancreatic transplants are less common than kidney or liver transplants and are usually performed in patients with type 1 diabetes. Our physicians perform isolated pancreas transplantation, simultaneous kidney/pancreas transplantation, and pancreas transplantation following kidney transplantation. Specialized care is offered in the following areas: Combined organ transplantation including kidney, kidney/liver, and kidney/heart Comprehensive tissue typing and immune evaluation services Follow-up and psychosocial support Leading-edge treatment options for immunosuppression Liver transplantation, including adult-to-adult living donor, pediatric living donor, and other surgeries Minimally invasive living-donor kidney surgeries Robotic hepatobiliary surgery Surgical therapy of diseases of the liver and biliary systems and end-stage kidney and liver disease Telemedicine via patient portal

The incidence of liver and bile duct cancer is growing, and about 42,000 new cases are diagnosed each year in the United States. While the incidence is rising, new surgical, interventional, and medical treatments are being added to our therapeutic armamentarium and are available to our patients. After treatment, our team of hepatologists provides continued care to manage the underlying liver disease, preserve liver function, monitor for possible recurrence of cancer, and re-treat, if necessary, while our medical oncologists apply systemic cancer treatment for those in need, as well as access to innovative medications through clinical trials. The Liver Cancer Program at Smilow Cancer Hospital has assembled a dedicated group of specialists, including hepatologists, hepatobiliary and transplant surgeons, diagnostic and interventional radiologists, pathologists, medical oncologists, and nurses. The team meets weekly at a NCI-designated tumor board to discuss each patient’s diagnosis and reaches a consensus on the best personalized treatment plan. Our guiding principle is to personalize and adapt care to the changing needs of the patient. Clinical trials, using new ablation treatment, new targeted agents, and combinations of treatments to target specific intracellular mechanisms of the liver cancer, are also available for patients with advanced disease. A combination of interventional radiology and surgical techniques, including ablation therapy, liver resection, new chemotherapeutic options, and liver transplantation, are available to our patients. For some patients, these treatments can cure their disease. For patients diagnosed with early disease, liver transplantation can provide definitive cure for both the cancer and advanced liver disease that frequently accompanies a diagnosis of cancer. For patients who do not have advanced liver disease or for those who cannot receive a liver transplant, surgical resection and ablative therapies such as transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) can provide excellent survival rates. TACE delivers chemotherapy through a catheter directly to the liver tumor. RFA is a common treatment method for small tumors and uses a direct current to destroy tumors. NanoKnife therapy is a state-of-the-art minimally invasive cancer treatment that applies a high voltage of electrical pulses to induce precision targeted cancer death, while minimizing surrounding tissue damage in the liver. After treatment, our onco-hepatologist team provides continued care to manage the underlying liver disease, preserve liver function, and monitor for possible recurrence of cancer and re-treat, if necessary.