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Pediatric Hepatology: Shaping Care Through Research

Pediatric liver disease presents several clinical challenges. Some babies develop progressive liver injury, eventually requiring transplant. After transplant, children face lifelong immunosuppression with potential toxicity.

The Pediatric Liver Center at UCSF Benioff Children’s Hospitals is addressing these problems through innovative research initiatives. The team’s recent National Institutes of Health (NIH)-funded trials and translational science could inform how clinicians manage these conditions and care for children after transplant.

Current liver disease research initiatives include:

1. Understanding immune tolerance in the neonatal liver

Amar Nijagal, MD , a pediatric surgeon and physician-scientist at UCSF, secured a four-year, $3.17 million R01 grant from NIDDK.

The Nijagal Lab is using two approaches:

  • Gene editing. CRISPR-Cas9 enables precise study of immune regulation by eliminating MARCO signaling.
  • Direct portal vein injection. Enables identification of antigen-specific responses within the liver.

This research focuses on underlying immune mechanisms and may enable earlier intervention in diseases like biliary atresia.

2. Tailoring immunosuppression after liver transplant

Emily Perito, MD and colleagues are optimizing long-term outcomes for pediatric transplant patients.

A multicenter NIH trial led by Sandy Feng, MD, PhD aims to identify biomarkers for reducing immunosuppression safely.

Chronic immunosuppression carries risks such as infection and malignancy. Precision approaches may reduce these risks while maintaining graft health.

Multidisciplinary, collaborative approach

The UCSF Pediatric Liver Center integrates research with multidisciplinary clinical care.

  • Hepatologists
  • Liver and transplant surgeons
  • Nutritionists
  • Pathologists
  • Specialized nursing staff

The center offers coordinated care, consultations, and second opinions while maintaining collaboration with referring providers.

Early referral helps optimize care before disease progression, though the team supports patients at all stages.

To refer a patient to the UCSF Pediatric Liver Center, visit our referral page or call (877) 822-4453 .