Departments

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

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.

When children or adolescents have urological conditions, it can affect the whole family. We know that any diagnosis or corrective surgery can be scary for a child—and for the parents, too. Our doctors strive to provide detailed answers about the child’s condition and treatment options. We have expertise in treating the full range of conditions, including incontinence, stone disease, spina bifida, and urologic fetal anomalies, with a special emphasis in complex urogenital reconstruction and stone disease in children. Our skilled physicians and surgeons handle everything from simple checkups and circumcisions to reconstructive surgeries for differences in sexual development. The Differences/Variations in Sexual Development Program is one of our multidisciplinary programs featuring a team of specialists that includes pediatric endocrinology, urology, genetics, pediatric and adolescent gynecology, psychology, and social work. The team is available for consultation on patients with atypical genitalia and other hormonal or genetic issues impacting sexual development. These can include congenital adrenal hyperplasia, androgen insensitivity, Klinefelter's syndrome, Turner's syndrome, hypospadias, and other variations that may impact sexual development. Our Spina Bifida program also offers a multidisciplinary approach. Loss of bladder control can result from an injury or developmental problems of the nervous system. We can help deliver treatments that restore independence and make symptoms more manageable. Our Bladder and Continence Program helps children with a wide range of urinary issues, including daytime accidents and bedwetting, urinary tract infections, and lower urinary tract symptoms.

Our nephrologists offer comprehensive, compassionate care to children with acute and chronic kidney diseases and hypertension. We provide the complete spectrum of nephrology care from infancy to adolescence for patients from our local community and across the Northeast. Common conditions we treat include: Congenital kidney abnormalities Glomerular and vascular diseases Tubular diseases Polycystic kidney diseases Urinary tract abnormalities Hypertension Acid base disorders Fluid and electrolyte abnormalities Acute chronic renal disease End-stage renal disease Kidney transplants Nephrolithiasis Diabetic nephropathy

Our nationally ranked team of caregivers are experts in diagnosing and managing a broad range of acute and chronic kidney diseases, both in the inpatient and outpatient settings. We offer around-the-clock primary care to patients with established renal disease or hypertension, and our physicians are readily available for consultation on newly referred patients. Our services are comprehensive. In some cases, we consult and collaborate with other doctors and work hand-in-hand with referring providers. In other circumstances, we are principal caregivers for our patients. In nearly all instances, our care is multidisciplinary, involving other physicians and specialists, nurse practitioners, physician associates, and skilled nurses. We are committed to: Being available 24/7 to our patients and referring physicians Open communication with patients, families and referring physicians Applying new approaches to treating and diagnosing renal diseases and their complications Advocating for our patients We offer: A dedicated nephrology floor at Yale New Haven Hospital A large outpatient peritoneal dialysis practice and home hemodialysis practice Clinical trials on the cutting edge of polycystic kidney disease (PKD) that attract patients from surrounding areas and states. Weekend seminars for patients with PKD and inherited kidney disease Dedicated subspecialty services for inherited kidney diseases, hypertension, cardio-renal syndrome, onco-nephrology, and kidney disease in pregnancy Our special services include evaluating and caring for patients with: Acute kidney injury Cardiovascular dysautonomia (e.g., orthostatic hypotension) Chronic kidney disease Diabetic kidney disease Dialysis therapies Electrolyte and/or acid-base disorders Glomerular diseases/Glomerulonephritis Hypertension Inherited kidney diseases Kidney disease and hypertension in pregnancy Kidney disease in cancer Kidney disease in heart failure Kidney transplantation Nephrolithiasis Polycystic kidney disease Largest—and rapidly expanding—kidney transplant program in New England with multidisciplinary care clinics Inherited kidney disease program, with coordinated access to multidisciplinary care for extra-renal disease, advanced genetic testing, and counseling Joint nephrology/urology kidney stone program for management of complex nephrolithiasis Multidisciplinary hypertension program for advanced diagnostic evaluation and management of complex hypertension and cardiovascular dysautonomia Advanced chronic kidney disease and end-stage renal disease program Dedicated nephrology floor at Yale New Haven Hospital Clinical trials and innovative research protocols in polycystic kidney disease, acute kidney injury, diabetic kidney disease, anemia in kidney disease, and peritoneal dialysis

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

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.

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

Polycystic kidney disease (PKD) causes fluid-filled sacs called cysts to grow in the kidneys. The cysts can become large and cause scarring, eventually harming the organs’ function. This disease is caused by a gene mutation, usually passed down by a parent. Polycystic kidney disease is typically diagnosed using imaging studies, such as ultrasound, which will show the cysts in the kidneys. A genetic test performed on a blood or saliva sample can detect the gene mutations that cause the disease. The Yale Medicine Polycystic Kidney Disease Program, recognized as a Center of Excellence by the PKD Foundation, offers patients the opportunity to receive care from experts who can explain the nuances of inherited disorders to patients and skillfully manage the illness. Yale Medicine offers opportunities for patients with polycystic kidney disease to take part in clinical trials, which aim to help doctors better understand the disease and evaluate new treatment approaches. The experts at Yale Medicine are also at the forefront of basic research into the mechanisms underlying cyst formation. By seamlessly combining clinical expertise with research engagement, we provide patients with the best care and knowledge the PKD field has to offer.

The Yale Pediatric Immunocompromised Host/Transplant Infectious Diseases Program, directed by Inci Yildirim, MD, PhD, MSc, provides ongoing medical care for children and adolescents with underlying conditions—or receiving treatments—that suppress the immune system, including solid organ or hematopoietic stem cell transplantation. In conjunction with the Yale Transplant Program, we conduct pre-transplant and post-transplant infectious diseases evaluations, as well as diagnose and manage infectious diseases in immunocompromised patients. Additionally, we offer counseling for infection prevention, specific infectious disease exposures, and travel planning with immunization recommendations. The Program is located in the Transplant Center at Yale New Haven Children's Hospital. Appointments may be made by calling the YM CARE Center at 1-877-925-3637 (1-877-YALE MDS).

Our program offers innovative care for patients with advanced and complex structural heart disease. From diagnosis to treatment, our team is dedicated to treating all forms of structural heart disease, some of which are congenital, or present at birth, and others that develop with age. We take the utmost care in treating these defects, which can affect the interior walls of the heart, the valves inside the heart, and the arteries and veins that carry blood to the rest of the body. As the first program in the state of Connecticut dedicated to the care of adult patients with complex congenital heart disease, we offer the full spectrum of care, providing regular inpatient and outpatient services to adult congenital heart patients. We offer an array of imaging, exercise testing, and surgical options, as well as less invasive catheterization therapies. Our multidisciplinary team includes interventional experts in congenital cardiac catheterization and electrophysiology who have decades of combined experience in the field. Our cardiothoracic surgical team has expertise in congenital heart disease and adult cardiac surgery with experience that spans three decades. Other members of the team include experts from the Yale General & Advanced Heart Failure Program, as well as a wide array of subspecialists in related areas, including liver and kidney disease. Adolescents and adult patients can expect to receive detailed education about their underlying congenital heart defect, its management, and the implications for future functioning. We ensure that our patients with pediatric congenital heart disease will be managed in the context of adult medicine with a multidisciplinary team that includes pediatric and adult cardiologists, adult pulmonologists, genetic counselors, and social workers. Our center provides state-of-the-art diagnostic imaging, including echocardiography and MRI. We work closely with Yale Medicine High-Risk Obstetric and Maternal-Fetal Medicine Programs to provide obstetrics and perinatology services to women with congenital heart disease, and we provide referrals for fetal echocardiography in cases where it is appropriate.