Gastroenterology, Hepatology, Nutritional Support and Paediatric Hepatic Transplants

Our centre’s Paediatric Gastroenterology Unit was founded in the early 70s by Dr Ramon Tormo, who was joined soon after by Dr Dámaso Infante. Together, they were pioneers in Paediatric Gastroenterology in Spain, and for more than three decades they consolidated this unit as one of the most recognised and prestigious nationwide.

Now it is known as the Gastroenterology, Hepatology, Nutritional Support and Paediatric Hepatic Transplant Unit, and is a reference centre for treating children with gastroenterological (digestive), hepatic (specifically liver and biliary tract) and/or nutritional illnesses.

Our Unit provides care for patients in the catchment area of Vall d'Hebron University Hospital, as well as taking over highly complex cases or patients that exceed the capacity of other hospitals, in both Catalonia and the rest of Spain.

The gastroenterology area is a multidisciplinary unit, dedicated to providing specialist, comprehensive, personalised care for patients affected by gastroenterological diseases, whatever the seriousness or number of cases among the general population. With more than 35 years of experience and a proven vocation for constant innovation in diagnosis and treatment, we continue to be pioneers in paediatric gastroenterology in Spain.

The multidisciplinary Hepatology Unit focuses on the needs of patients receiving liver transplants as well as patients affected by severe liver disease. With more than 25 years of experience, this unit is a pioneer in hepatic transplants in Spain, carrying out the first liver transplant in Spain in 1985.

It is now one of the most active units nationwide, and is a reference centre for liver transplants in children at the national level (CSUR). The unit treats children with severe liver disease and provides specialist, comprehensive, personalised care. 

The multidisciplinary Nutritional Support Unit, which is a part of the Transversal Nutritional Support Unit, works together with the Paediatric Gastroenterology Unit, treating all patients with special nutritional requirements (those affected by oncological diseases, nephropathy, complex heart disease, solid organ transplants (spinal cord, liver, kidneys, etc.), congenital metabolic defects, etc.).

In addition to providing comprehensive, specialist support, the unit has run a Home Artificial Nutrition programme since 1998, both enteral (by tube) and parenteral (intravenous), which applies nutritional support procedures to stable patients in their own homes, enabling them to leave the hospital and improve their quality of life.

This unit is also responsible for patients with Short Intestine Syndrome, which is part of the intestinal rehabilitation programme, whose main objectives are to maintain the nutritional status of patients and promote the intestinal adaptation of the remaining intestine. This programme has extensive experience in prolonged Parenteral Nutrition (management of central lines, infusion systems, family training, etc.) and paediatric digestive surgery (autologous reconstruction techniques, that is, using the patient’s own tissue) of the intestines, including STEP and Bianchi intestine-stretching techniques) of the kind that child patients require.

Our team consists of: a coordinator, Oscar Segarra; attending physicians, Marina Álvarez, Jesús Quintero, Javier Juampérez, Susana E. Redecillas and Raquel Núñez; Primary care colleagues specialising in this specialty at COAP Sant Andreu - Casernes, Rebeca Corral and Toni Muntaner; Nurses, Carmen Arenas and Lis Vidal. Also, as part of the Master’s in Paediatric Gastroenterology 2017: Maria Mercadal and Cinthia Virginia Flores. 

Thanks to our multidisciplinary team, with the collaboration of the staff and infrastructure of the General Hospital for adults, we can provide highly specialised, comprehensive medical and surgical attention to all patients who require it.

Portfolio of Services 

• Digestive function lab
• General and specialised hepatology
• Hepatic function lab
• General and specialised nutrition
• Liver transplant programme
• Cystic Fibrosis Unit

Research

The Unit regularly participates in studies and clinical trials. All these are approved beforehand by the centre’s Clinical Research Ethics Committee. The main lines of research are based on the application of new techniques and procedures that allow us to make improvements in the short, medium and long term in the diagnosis and/or treatment of certain pathologies:

• Application of flow cytometry to coeliac disease or inflammatory bowel disease.
• Application of scintigraphy with marked albumin in protein-losing syndrome or in certain congenital heart diseases.
• Consolidation of the transplant programme for paediatric refractory Crohn’s in haematopoietic progenitors
• Application of different elastography techniques (FibroScan and Acoustic Radiation Force Impulse) for evaluation of liver fibrosis in paediatrics.
• Application of new treatments for HBV and HCV.
• Participation in Selica IV multicentre European trials for hepatocyte transplants (Safety and Efficacy of Liver Cell Applications)
• Evaluation of Indocyanine green as a prognostic marker in acute liver failure
• Application of the Molecular Adsorbent Recirculating System (MARS (R)) in acute hepatic paediatric decisions and chronic liver disease flare-ups.
• Consolidation of the small intestine rehabilitation programme.

Teaching 

As a specialised reference unit, the Paediatric Gastroenterology Unit is responsible for significant teaching activity:

• Undergraduate: the Unit collaborates in the Paediatric training of medical students at the Vall d'Hebron Hospital Teaching Unit from the Faculty of Medicine of the Autonomous University of Barcelona (UAB): paediatrics classes, clinical case seminars and paediatric internships related to paediatric digestive pathology.
• Postgraduate-Medical Residency
• MIR Programme: Paediatric residents training at Vall d'Hebron University Hospital carry out a rotation at the Paediatric Gastroenterology Unit lasting 2 months, and have the chance to carry out extra voluntary rotations. The basic training objectives during these rotations are to learn about the processes related to our specialty. We cover the basic treatment of patients undergoing liver transplants; the basic nutritional management of patients with cystic fibrosis; and the basic techniques of digestive tract examination. In addition to residents of the hospital itself, the Paediatric Gastroenterology Unit frequently hosts paediatric residents from other hospitals who carry out a training period in our Unit. To undergo training here, medical residents (MIR) from other hospitals must make a request to the Vall d'Hebron University Hospital teaching committee.
• Postgraduate-Master's: the Unit’s objective is to train paediatricians in Paediatric Gastroenterology. Those interested can choose between two different formats: short-term training stays or long-term stays (1 year). The Master's Degree in Paediatric Gastroenterology is on site and lasts 1 year, admitting 2-3 students a year, and offering 60 ECTS credits (corresponding to 1,500 hours of student training and work).