Division of Pediatric Surgery
Surgeon-in-Chief, University of Maryland Children's Hospital
"Basic science and clinical research are an integral part of our mission. We are constantly looking for ways to improve quality of life for our babies and children." - Dr. Roger Voigt
Nationally recognized specialists from the University of Maryland Division of Pediatric Surgery apply the latest technological advances and proven surgical principles to a broad range of complex pediatric surgical problems.
Our pediatric surgery faculty are part of a multidisciplinary team whose care may begin before birth thanks to early diagnostic imaging techniques once thought impossible. We bring innovative specialty treatments to patients from birth through 18 years of age, using the broad resources of an outstanding academic medical research institution. We provide care that is second to none, and in many cases save the lives of children whose families had been given little to no hope for their child’s recovery.
Specialty areas include a multitude of complex problems including Head and Neck, Thoracic, Abdominal, and Urologic diseases and defects.
Basic science and clinical research are an integral part of our mission. We are constantly looking for ways to improve quality of life for our babies and children.
Short Bowel Syndrome Research
The Intestinal Rehabilitation Program at the University of Maryland Children’s Hospital was founded in 2009 by Dr. Samuel M. Alaish, assistant professor of surgery. This program brings together specialists from pediatric surgery, pediatric gastroenterology, nutrition, pharmacy, nursing, speech therapy and social work to create a coordinated, thorough approach to the care of patients diagnosed with Short Bowel Syndrome (SBS). Although progress has been made, there remains a high mortality rate for these babies and significant research is underway to focus on new ways to prevent or treat this complex disease.
SBS patients require long-term intravenous nutrition. Many complications ensue following prolonged intravenous nutrition, including intravenous catheter infections, cholestasis (stagnant bile flow from the liver into the intestine), liver failure and failure to thrive. If intravenous nutrition-induced liver failure progresses, small bowel and liver transplant become the only treatment option for these infants. 30 to 40% of transplant patients die after 5 years. The survivors have growth disturbances from the immunosuppressive medications required. And those are the lucky ones; some of the SBS infants do not survive long enough to receive a transplant. Their deaths are attributable to infections and intestinal failure-associated liver disease.
The organisms often responsible for these lethal infections originate from the gut. An unhealthy gut which leaks bacteria into the bloodstream is thought to be the most likely cause. Dr. Alaish’s laboratory has found an exceedingly high level of a bacterial toxin in the bloodstream in a mouse model of cholestasis.
His research is now focused on studying whether a vaccine targeted against this toxin will prevent deaths. Dr. Alaish’s laboratory is also exploring mechanisms whereby we can augment the body’s own defense systems to fight infection. This has been described in other intestinal diseases and we believe it holds promise for these vulnerable patients.
Research focused on the mechanisms underlying this pathophysiology demands attention and we are determined to find ways to improve outcomes and options for children who suffer with this difficult and sometimes fatal condition.