Multidisciplinary Programs:

The Division of Surgery participates in a number of multidisciplinary programs and clinics. These partnerships with other medical divisions at the hospital greatly enhance our ability to provide comprehensive treatment and broad
expertise in treating the most complex cases and the most medically fragile children.


Multidisciplinary Cardiac Care Team
The multidisciplinary cardiac care team provides inpatient and outpatient diagnosis and treatment for the full range of pediatric congenital or acquired heart disorders. A dedicated, internationally renowned team of pediatric cardiac surgeons, cardiologists, pediatric intensivists, neonatologists, anesthesiologists and nurses offer comprehensive, multidisciplinary care for the young heart patient. The team serves neonates, infants, children and adolescents with end-stage cardiopulmonary failure, acquired or congenital heart disease or who are waiting for or recovering from transplantation surgery.

Physician teams perform more than 350 cardiac operations and 600 cardiac catheterizations each year. For patients with heart defects, such as atrial septal defects or patent ductus arteriosis, interventional catheterization provides a less invasive alternative to surgery. “Simple” valve or vessel repairs are accomplished with the newest minimally invasive techniques. Complex cases such as hypoplastic left heart syndrome and transposition of the great arteries are managed using a team approach involving surgeons, cardiologists and a broad range of medical specialists. A dedicated cardiac intensive care unit provides the best in post-operative care.

Cooperative clinical research projects examine surgical outcomes, interventional cardiology outcomes, and the efficacy of heart medications. Educational programs for surgery, cardiology and critical care fellows are actively pursued.

Parent support groups provide specialized services and support to parents and family members of the Multidisciplinary Cardiac Care Team patients.

The multidisciplinary cardiac care team also offers the Shapedown Clinic. The Shapedown Clinic is one of the nation’s leading weight-loss programs for adolescents and children, providing a family approach to childhood and adolescent obesity.

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Heart Transplant Program
The Children’s Hospital Cardiac Transplant Service is associated with the University of Colorado Health Sciences Center Transplant Program, which was initiated in 1986. Since 1990, all pediatric patients receive transplants at The Children’s Hospital. In 2002, the program performed its 200th pediatric heart transplant. The program has had the highest overall volume in the country for the past five years.* Not only do the surgeons and cardiologists at The Children’s Hospital perform more heart transplants than any other hospital across the U.S., their first-year patient and graft survival rates are the best in the country.* Charges per case and length of hospital stays are lower than the national average.*

The newly dedicated cardiac intensive care unit (CICU) is staffed by nurses and technicians specifically trained in pediatric cardiac medicine. The unit offers the highest quality post-operative care for transplant patients.

In addition to the surgical and nursing expertise available at Children’s, the program offers comprehensive support programs for the young patient and their families. The program partners with the United Network of Organ Sharing (UNOS) nationally and the Donor Alliance locally to track availability of organs. Dozens of family services are available from pastoral care and support groups to financial aid and help with planning the details of temporary relocation and childcare for siblings.

* Data is cross-referenced between the United Network of Organ Sharing (UNOS) national database and the Scientific Registry of Transplant Recipients (U.S. Transplant) national database. Volume figures cover the period of 1998 through 2002. First year patient and graft numbers cover the period of 7/99 through 6/01, the most recent available national figures.

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Liver and Kidney Transplant Program
This winter, The Children’s Hospital Liver and Kidney Transplant Service reached the 100th transplant mark for both liver and kidney transplants. Patient and graft survival rates exceed the national average. The multidisciplinary team includes pediatric transplant surgeons, pediatric gastroenterologists, pediatric nephrologists, pediatric urologists, pediatric clinical nurse specialists, registered dietitians and social workers.

The Liver Center, a joint program between Gastroenterology and Pediatric Surgery, serves a national referral population of children with liver and bile duct disease. The Kidney Center serves as the regional resource for pediatric renal patients. The center supports hemodialysis and peritoneal dialysis patients, as well as doing follow-up on kidney transplant patients.

Partnering with the pediatric General Clinical Research Center at The Children’s Hospital, transplant surgeons continue to pioneer techniques and protocols for liver and kidney transplantation as well as other surgical interventions for liver and kidney diseases. The research team at Children’s did the preliminary research and development of the Kasai procedure, used across the globe for the treatment of biliary atresia. Committed to the advancement of transplant surgery, the program initiated its first fellowship in pediatric transplant in 2002. The Children’s Hospital is one of only a handful of pediatric hospitals in the country offering a fellowship in transplant surgery.

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Endoscopy Program
Surgical endoscopic cases at The Children’s Hospital have risen dramatically over the last four years. From 1999 to 2000, more than 400 endoscopic operations were performed. These numbers increased dramatically to 850 laparoscopic and thorascopic cases from 2001 through 2002. This increase is largely due to broader applications for minimally invasive techniques and advances in technology allowing these procedures to be performed on smaller and sicker infants and children. More parents are requesting endoscopic alternatives for their children after independent research on the Internet or discussion with other families. Furthermore, we are evaluating a robotic surgical system that will expand minimally invasive applications in general pediatric surgery, pediatric urology and pediatric cardiac surgery.

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Correction of Thoracic and Spinal Deformities
The Department of Pediatric Surgery is active in the correction of thoracic deformities. These include primary correction of pectus excavatum, pectus carinatum, and Poland’s Syndrome, and secondary participation in the realignment of scoliosis, kyphosis, and lordosis with the Orthopaedic Surgery Department. Nationally, pectus excavatum repair has undergone a revolution. It was once a brutal, painstaking operation requiring several hours and prolonged recuperation. Now, the Nuss Procedure is minimally invasive, takes less than two hours in the operating room and allows kids to return to normal activities within four weeks. Members of the department have performed the procedure for the last three years. To date, fifty children, ranging in age from six to 18 years, have benefitted from the Nuss technique.

Additionally, members of the department continue to assist the Orthopaedic Surgery Department in the exposure of the anterior aspect of the spine. Exposures are complicated surgical procedures, which demand the highest level of surgical anatomy experience to deliver an operative field appropriate for orthopaedic intervention on the deformed spine.

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One of eight General Clinical Research Centers in the Country

The Colorado Pediatric General Clinical Research Center (GCRC) was established in 1962. In 1990, the center was moved to The Children’s Hospital. The National Institutes of Health (NIH) supports over 80 GCRCs in the U.S. Only eight of these are dedicated solely to pediatric research. In 2001, the GCRC at Children’s received a $16 million grant to fund research over the next five years, one of the largest research grants received by Children’s.

Pioneering protocols include pediatric AIDS research, Type II diabetes research, the use of hypertonic saline preoperatively to improve surgical outcomes and the use of autologous fresh blood in cardiopulmonary bypass. The pediatric GCRC at Children’s pioneered the initial research and development of the Kasai procedure. The Kasai is now the standard surgical intervention for biliary atresia across the world.


Recent studies include inflammatory responses to surgery, cellular responses to trauma or surgery, dose finding for
anticoagulants that work with kids and the study of synthetic blood products.