2019 - Webinar Series on Liver (2018-2019)

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Challenging Problems in Pediatric Liver Transplantation

2.1 - Challenging Problems in Pediatric Liver Transplantation: Long Term Allograft Attrition

Presenter: Carlos O. Esquivel, Simon P. Horslen, Stanford, CA, USA
Authors: Carlos O. Esquivel, Simon P. Horslen, Sukru Emre


The discussants would like to make the case that the most difficult and yet the most important problem we face in Pediatric Liver transplantation is long term allograft health. While short term outcomes have improved dramatically, the long-term rate of graft fibrosis and graft loss has really not changed, and because of the age of pediatric patients at the time of transplant most of the morbidity falls on the adolescents and young adults.

Carlos O. Esquivel Biography:

Carlos O. Esquivel is Professor of Surgery at Stanford University School of Medicine, Chief of the Division of Abdominal Transplantation and the Associate Director of the Institute of Immunity, Transplantation and Infection, an umbrella institute that fosters interdisciplinary research between basic scientists and clinicians. Dr. Esquivel is the first recipient of the Arnold and Barbara Silverman Professorship in Transplantation. He received his M.D. degree from the University of Costa Rica School of Medicine, completed general surgery training at the University of California Davis and then obtained a doctoral degree from the University of Lund in Sweden. He trained in transplantation of the liver, kidney, pancreas and intestine at the University of Pittsburgh under the direction of Dr. Thomas Starzl. In 1995, he was recruited to Stanford to start the Pediatric Transplant Programs at LPCH and rebuild the Adult Liver and Kidney Transplant Program.

Dr. Esquivel is recognized worldwide as an expert and pioneer in transplantation. He is a creative and productive investigator having contributed 338 publications in the medical literature and given over 200 lectures throughout the United States and internationally. He oversees multiple basic science and clinical research projects and is currently PI for a 5-year, multi-center NIH grant to develop biomarkers for Epstein-Barr Virus-induced post-transplant lymphomas in children. As a transplant leader at Stanford and in key national and international societies, he promotes team cooperation, embraces change and creates an environment for fostering discovery, and for training leaders of the future. In recognition of his many contributions to surgical education, Dr. Esquivel received the American Society of Transplant Surgeons 2015 Francis Moore Excellence in Mentorship in the Field of Transplantation Award.

Simon Horslen Biography:

Simon Horslen MB ChB FRCPCH FAST FAASLD is a Professor in the Division of Pediatric Gastroenterology, Hepatology & Nutrition at Seattle Children’s Hospital and the University Of Washington School Of Medicine. He is Medical Director for Solid Organ Transplantation at Seattle Children’s Hospital. Dr. Horslen earned his medical degree at the University Of Bristol, England and is a Fellow and Founder Member of the Royal College of Paediatrics and Child Health.

He has worked in the US for the last 20 years initially at the University Of Nebraska Medical Center and currently in Seattle. He is a Pediatric Hepatologist and Transplant Physician with many years’ experience of liver and intestinal transplantation in children. Dr Horslen participates in several multicenter research studies including SPLIT (Studies in Pediatric Liver Transplantation), PALF (Pediatric Acute Liver Failure) and ChiLDREN (Children’s Liver Disease Research Network). Dr Horslen is a past-Chair of the UNOS/OPTN Pediatric Committee and of the Pediatric Community of Practice of the American Society of Transplantation (AST). He is current Chair of SPLIT (Studies of Pediatric Liver Transplantation) and President Elect of IRTA (Intestinal Rehabilitation and Transplantation Association).

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