Hepatology Program

Our Hepatology Program includes the Northwest’s only dedicated pediatric hepatologists: Drs. Niviann Blondet, Evelyn Hsu, Pamela Valentino, and Katelyn Saarela.

We care for liver patients every day. We have experience treating all liver conditions with the most state-of-the-art medical therapies and surgical techniques. Every day we strive to improve the care that is available to children. Through our dedication to clinical research, we hope to be able to prevent or change the course of pediatric liver disease in the future.

Our team will work with you to create the treatment plan that will best meet your child’s needs. All care providers work off this same care plan and will sit down with you and your child to discuss the plan and answer your questions. On your first visit with the Hepatology Program team, you and your child see a doctor and a nurse. A social worker and registered dietitian are here for consultation if needed.

Throughout their treatment and clinic visits, most children will see all the doctors in the Hepatology Program. We believe that this approach, rather than seeing the same doctor every time, is a real benefit to children with chronic disease. Your child gets the attention and knowledge of many experts, and each doctor on the team gets to know your child and understand their history and challenges. Any one of us can answer your questions and help you evaluate options at any point during your child’s care.

Doctors in the Hepatology Program also work closely with these teams: 

• Biochemical Genetics
• Endocrinology
• Interventional Radiology
• Psychiatry and Behavioral Medicine
• Pediatric surgeons and anesthesiologists
• Transplant Center

These partnerships help us make complex diagnoses and devise and carry out complex care. We make recommendations for other caregivers when needed and help you coordinate your appointments.

Our Hepatology Program team members are also on the liver transplant team.  Dr. Evelyn Hsu is the medical director of our Liver Transplant Program. If your child has serious liver disease and transplantation is being discussed, the Hepatology team can answer questions you have about what happens next and what to expect. If your child requires a liver transplant, many of the same caregivers will follow them through the transplant process. Children who receive liver transplants at Seattle Children’s have some of the best outcomes in the nation.

At Seattle Children’s we treat your whole child, not just their symptoms. We understand that being sick is hard on kids and their families. Members of our care team include child life specialists, psychologists and social workers who care for the mental and emotional health of you, your child and family. We welcome your questions and concerns about how your child’s illness, medicines or surgery will affect their quality of life.

Our program has a strong focus on nutrition. Unlike most adults with liver disease, many of the children we see have liver problems that they were born with or that started at a very early age. Because the liver breaks down nutrients, kids with liver disease often have trouble growing. Our nutritionists work with you and your family to make sure that your child receives the proper nutrients to let them grow and have energy to do the things they love to do. We are here to support you, from finding foods your child can tolerate to working with home care to provide food supplements or nutrition for a child on total parenteral nutrition (TPN).

We care for patients from a large region that includes the Pacific Northwest, Idaho, Alaska, Hawaii, Montana and Wyoming. We want to deliver the best care in a way that families can manage. We know that travelling to Seattle Children’s hospital campus is not always feasible. In these cases, we often practice “shared care.” In shared care, your child’s treatment is directed by our team, but some appointments are at one of Seattle Children’s outreach clinics or the office of another gastroenterologist near you.

For those families that do need to travel long distances, our social workers and Guest Services can help find hotels or other places to stay. Read more about options such as hotels, RV parks and Ronald McDonald House.

We are actively researching and developing new treatments for liver disease in children. We’re able to offer many treatments that are available only through clinical studies. This means our patients have access to some of the most current, state-of-the-art therapies. We are currently participating in research aimed at improving care for children with the following conditions: 

• Acute liver failure
• Alagille Syndrome
• Autoimmune hepatitis
• Biliary Atresia
• Biochemical genetic diseases
• Cholestatic liver disease
• Liver transplantation
• Metabolic dysfunction-associated steatotic liver disease (MASLD/MASH/NASH/fatty liver disease)
• Portal Hypertension / Portal Vein Thrombosis
• Primary Sclerosing Cholangitis
• Viral hepatitis

Many drug treatments for liver disease that are approved by the U.S. Food and Drug Administration (FDA) for adults aren’t approved for children. We participate in clinical trials to bring these treatments to children.

To take part in one of our studies or learn more, please contact one of our research coordinators. Read more about the research our hepatologists are doing.

• Harvoni use in young children with hepatitis C. The drug combination ledipasvir/sofosbuvir (Harvoni) acts directly on the virus that causes hepatitis C. Studies show that it is nearly 100% effective in clearing the virus. This direct-acting antiviral drug was previously approved for hepatitis C treatment only for adults.
  
  In recent clinical trials, children ages 3 to 12 and teens with hepatitis C were treated successfully. This success influenced the Food and Drug Administration’s (FDA) approval of Harvoni for children ages 12 to 17 in 2017.
  
  Currently, Seattle Children’s is able to provide Harvoni and other direct-acting antiviral drugs to hepatitis C patients as young as age 3 through clinical trials.
  
  Traditional hepatitis medicine is given by injection, but Harvoni can be given by mouth. This makes it much easier for young children to tolerate treatment.

• Fibroscan: Noninvasive imaging for liver biopsies. Seattle Children’s is able to make Fibroscan available to children as part of our research. We use this noninvasive technique to see how much scarring is present in a child’s liver. Fibroscan is not available to children at most medical centers.