Clinical Research Team Identifies Causes of Acute Liver Injury in Children

A specific cause of acute liver failure is not identified in the majority of pediatric patients. Based on a hypothesis that immune dysregulation may explain these indeterminate cases, Dr Becca Berquist, The Elizabeth and Russell Siegelman Research Fellow in Pediatric Gastroenterology, developed a multidisciplinary clinical protocol to better identify and treat immune-mediated causes of acute liver injury in children. Dr Berquist assembled a group comprised of over seven pediatric sub-specialty services including Gastroenterology/Hepatology, Hematology, Allergy/Immunology, Infectious Disease, Interventional Radiology, Pathology and Transplant Surgery. Using early liver biopsy and special pathologic staining, they exclude active infection and if an immune-mediated cause is possible, proceed with immune therapy. Based on clinical success, they are conducting both retrospective and prospective studies to compare to historical outcomes and better understand the underlying mechanisms of injury.

CHRI has also been instrumental in supporting an additional study involving a text-messaging intervention to improve adherence to laboratory testing in adolescent liver transplant patients. Reminder messages are sent based on the laboratory frequency prescribed and alert patients automatically of their need for testing. The intervention will last a total of one year at which time the impact will be analyzed. However, within the first month the benefits were already evident. One patient, who had been inconsistent with obtaining lab tests, had them checked after receiving a text-based reminder. The tests showed he had developed liver failure so he was hospitalized immediately and eventually received a second liver transplant. Dr Berquist and her team are eager to formally analyze the results on the entire group for this low-cost technologic intervention.