Achieving Racial Equity in Transplants: Seattle Children’s Dr. Evelyn Hsu’s Mission

Seattle Children’s recently named Dr. Evelyn Hsu the division chief of Gastroenterology and Hepatology. For more than a year, Hsu was the acting chief while a national search was conducted.

In this interview, Dr. Hsu talks about her extensive medical career, her vision for the future and what hope, care and cures mean to her. Read on to hear more about her incredible journey and her passion for helping children live the most fulfilling life possible.

Meet Dr. Evelyn Hsu

Dr. Evelyn Hsu, Seattle Children’s Division Chief of Gastroenterology and Hepatology, wants to ensure racial equity in transplants.

Hsu is a pediatric gastroenterologist and transplant hepatologist, clinical researcher and advocate for pediatric liver allocation. She has worked in collaboration with others to successfully change U.S. policy to help better prioritize pediatric patients on the liver waitlist and holds leadership positions on national committees. Hsu is the current chair of the United Network for Organ Sharing and is the president-elect of the Society for Pediatric Liver Transplantation. She has served as chair of the Education Committee for SPLIT and was the founding chair of the Advocacy Committee.

Her experience brings together care, research and a passion to do the very best for children who need organ transplantation. These areas of expertise intertwine to make Hsu a compassionate force for good, and a great leader to usher in the next generation of gastroenterologists and hepatologists.

“I love my job. It is a great honor and privilege to partner with patients and their families as they adjust to the challenges of their diagnosis and see that hope and happiness can lie beyond their difficult journey,” said Hsu. “They, along with the amazing team I partner with here at Seattle Children’s, are a daily inspiration. I believe that we can achieve the ideal outcome for every child and allow them to realize their life’s dreams; this is what drives me forward in both my clinical work and research.”

Hsu has been with Seattle Children’s since 2011. She earned a medical doctorate degree with honors from the University of Wisconsin in 2003 and completed pediatric residency training at the University of Washington and Seattle Children’s Hospital in 2006. She went on to pursue a subspecialty fellowship at the Children’s Hospital of Philadelphia.

She said she has always been drawn to the West Coast and knew Seattle was where she wanted to end up.

“It was always our hope to come back and serve the unique population that Seattle Children’s serves,” Hsu said. “I feel like my roots are here, partially because of the excellent training I had while I was here.”

The Best Outcomes Possible for Every Child

Asking tough questions is something Hsu doesn’t mind doing.

“Every day, we ask ourselves, ‘What are the pressing questions families want answers to?’ And then we determine how we can work quickly and collaboratively, leveraging registries and big data, to find out the answers,” Hsu said.

One of those questions revolves around ideal outcomes post-transplant. An ideal outcome means a child is living with their organ and has not been retransplanted, doesn’t have cancer and doesn’t have rejection.

Seattle Children’s providers are among the most experienced liver transplant surgeons in the U.S., and the outcomes of patients who receive liver transplants are among the best in the nation.

“We know about 30% of children have that ideal outcome 10 years after transplant,” Hsu said.

But the question that keeps Hsu up at night is, why don’t all children have that outcome?

One of the most powerful indicators, according to Hsu, is race.

“We need to know what puts these kids at risk and address them so we can treat the whole patient and their circumstances and not just their disease,” Hsu said. “These are some big problems – societal problems are big problems but that doesn’t mean we shouldn’t look at them or try to solve them.”

Through advocacy, Hsu has used her skills to change policy and believes that she, with the community, can work together to change the world so that kids can have better outcomes.

“The bottom line is that liver transplantation is a miracle,” Hsu said. “You take a kid who is basically right at the edge, almost dying. You grab them back from the jaws of death and give them a liver transplant, and they are essentially restored to life.”

But today, kids are dying waiting.

“When I started my work about 10 years ago, I asked the questions, ‘Why are some kids getting this and others not? Why doesn’t every child have the opportunity to live an amazing life and experience that miracle?’” Hsu said. “It didn’t take very long in doing research to find out that there are some kids who have a leg up, and there are some specifically disadvantaged kids. That goes against the grain of why we show up to do the work we do. That shouldn’t be happening. So, I will keep asking, ‘Why? Why isn’t there change?’”

Throughout her career, Hsu says she has heard plenty of answers to her questions. However, she can’t accept them.

“The answer to the why is often racism,” Hsu said. “It’s structural racism, institutional racism, interpersonal racism that makes it so one child lives while another dies. I think that at my root, I can’t accept that. I’ve been told, ‘good luck,’ or ‘you have to be patient’ – but I simply don’t find those answers acceptable. We did change the policy for pediatric allocation for livers. There’s some distance to go, and we need to continue that important work. It’s not impossible – it’s not easy, but it’s not impossible.”

Hsu says she hopes to see strides forward in her life.

“I would like to think that things will change, or at least I have died trying to make a change,” she said.

Training the Next Generation

“Our overwhelming drive is to provide excellent clinical care, further medical knowledge and train the future generation of leaders in pediatric gastroenterology and hepatology,” Hsu said. “That’s our mission. What we’re saying is all those things tie into each other and enhance each other. Our research enhances our clinical care, our clinical care enhances research and everything we do is intertwined around those three basic missions.”

The goal of the team is to provide the best care possible and to help every child get back to growing, learning and doing what they love best – being a kid.

Hsu says she also wants to incorporate an equity lens into everything they do.

“It all starts with research,” Hsu said. “What we want to do is continue to do all of the amazing work we’re already doing but also push boundaries.”

“I believe that thriving academic physicians provide excellent care,” Hsu said. “If they are thriving – if they can love their jobs – the care and research they provide will be much more excellent.”

As the division chief, Hsu says she is excited to help make that vision a reality – to help others thrive, so children can thrive too.