May 14, 2019

Not too long ago a child with hepatocellular carcinoma – a rare liver cancer – would have few options for treatment and even fewer chances of long term survival.

In most cases, these tumors are discovered so late that surgery and transplant are not viable options to save a young child’s life. Families could hope for recovery, but the odds would not support their optimism.

The good news is that today is a new day.

A multidisciplinary team, led by Dr. Kamlesh Kukreja, expert in Interventional Radiology; is successfully performing the Trans-Arterial Radioembolization procedure – called TARE – on children who have this rare disease.

“There are only three hospitals in the country performing TARE and we are one of them,” Kukreja said. “We are the only one in the state of Texas.”

He added that TARE has the potential to regress tumors and help patients live with their own liver or keep the tumor in control until a liver transplant is available. An additional advantage is that TARE is an outpatient procedure, which allows the child to recover at home.

How it all works

TARE is administered in two steps. Step one involves identifying the angiographic anatomy of the tumor mapping the vascular supply of the cancer to assess how much radiation it can handle, while still keeping the patient safe.

“Two to four weeks after this mapping, the patient returns for the radioactive chemical agent – called Yttrium-90 (Y90) – to be administered directly to the artery supplying the tumor,” Kukreja said. “This administration is targeted and direct, which allows for higher doses of radiation to be administered with minimal side effects; unlike systemic chemotherapy, which has been found to not work well in these cases.”

Record of Success

Kukreja has successfully performed TARE on two patients to date with one patient showing a clear regression in the growth of the tumor allowing complete surgical resection.

Although Texas Children’s is one of the pioneers of TARE in pediatrics, it’s important to note that TARE is a frontline therapy at adult hospitals for patients with the most common type of liver cancer. Accumulating evidence from studies with adult liver cancer suggests that TARE is a promising strategy which may benefit children as well.

The people that make It possible

“We are very proud of what we have been able to accomplish so far and the way we have raised the standard of care for our patient families,” Dr. Kukreja added. “We are also proud that a multidisciplinary team has made this possible.”

The decision to use this approach is first made by a multidisciplinary team involving:

Dr. Prakash Masand, Radiology
Dr. Andras Heczey, Oncology
Dr. Sanjeev Vasudevan, Pediatric Surgery
Dr. John Goss, Transplant surgery

The hands-on clinical teams at Texas Children’s include interventional radiology, nuclear medicine, radiation safety, anesthesia and Dr. Armeen Mahvash, associate professor at M. D. Anderson Cancer Center.

To Learn More

If you know a patient who could benefit from this treatment, please reach out to the department of Interventional Radiology at 832-824-5565 or liver tumor team at https://www.texaschildrens.org/departments/liver-tumor-program. Dr. Kukreja can be reached at kukukrej@texaschildrens.org/kukreja@bcm.edu.

 

It’s hard to contain the celebration of nursing to just one week at Texas Children’s. Every day there are inspirational stories that demonstrate how our nurses go above and beyond to advance patient care and enhance patient experience and outcomes.

Their endless compassion, comfort and support can be seen and felt across the organization. A nurse clutching the hands of a parent who just received tough news about their child. A nurse giving up family time during holidays and weekends to spend time with families in the hospital. A nurse calming a mother’s fear as she prepares to give birth to her first child. Our nurses leave a lasting impression on every patient they encounter, and they are at the core of the experience patients and families have while in our care.

Each year, as we salute nurses across the country from May 6 to 12, Texas Children’s celebrates our amazing team of more than 3,500 nurses. The theme for Nurses Week this year was 4 Million Reasons to Celebrate – and at Texas Children’s – there are many reasons to celebrate our nurses.

This video spotlights our nurses’ many successes, accomplishments and the daily contributions they make to our patients and families at Texas Children’s.

Nurses Week activities

Texas Children’s Nursing Retention Council organized several fun activities throughout the week that included cookie deliveries to the units, blessing of hands and photo opportunities with our therapy dogs, Pinto and Bailey. Chair massages and other activities during Nurses Week centered on health and wellness to remind our nurses how important it is to take care of themselves so they can provide the best and safest care to their patients.

On May 8, Texas Children’s leadership hosted the Nursing Excellence Awards honoring seven recipients for their commitment to improving nursing care and patient outcomes.

The award honorees included:

Staff Nurse of the year: Anita Hadley
Preceptor of the year: Sherri Forschler
Rookie of the year: Jennifer Nguyen
Leader of the year: Sondra Morris
APRN of the year: Gina Santucci
Advanced degree of the year: Sharon Staton
Friend of Nursing: Dr. Matt Musick

Sandra Diaz and Erika Ramirez received the 2019 David and Polly Roth Nursing Education Scholarship Fund. This education fund will provide tuition assistance for Texas Children’s employees who have worked in the organization for at least three years and are interested in pursuing a professional nursing degree.

Faith Williams, Melissa Yu, and Lisa Carr received the Molly Mae LeBlanc Nursing Education Scholarship. The scholarship was named in memory of Molly Mae, daughter of Texas Children’s employees Jill and Andy LeBlanc, who passed away at Texas Children’s on May 6, 2017. The purpose of the scholarship is to perpetuate Molly Mae’s memory and recognize nursing staff members for going above and beyond their required job duties to enhance the quality of life for Texas Children’s patients and their families.

Priscila Reid, a nurse practitioner at Texas Children’s Heart Center, was among the top 15 award recipients from the Houston Chronicle Salute to Nurses, and 22 Texas Children’s nurses were recognized as being among the top 150 in the Greater Houston area:

Sheena Antimo
Nakeisha Archer
Angela Baldonado
Megan Beach
Janet DeJean
Nicole Dumas
Corey Gates
Jason Giangrosso
Nicole Harris
Josh Hearne
Lastenia Holton
Barbara Levy
Paul Longoria
Mona Lisa Macapagal
Tammy Myers
Virginia Plumlee
Priscila Reid
Esmeralda Reyna
Lisa Rohaly
Melissa Silvera
Kenya Starks
Elizabeth Watson

Congratulations to our nurses!

To learn more about Nursing at Texas Children’s, click here to view By the Numbers.

EpicCare Link is a web-based provider portal for Texas Children’s that gives referring physicians and their staff secure and convenient access to the hospital’s electronic medical record (EMR).

Texas Children’s EpicCare Link can be used by:

  • Staff at practices that are not part of Texas Children’s but whose providers are active, courtesy or consulting members of the Texas Children’s Hospital medical staff.
    Community providers, including Texas Children’s adjunct medical staff and their staff.

Once registered and logged in to Texas Children’s EpicCare Link, referring physicians can access important information about their patient’s care at Texas Children’s, including discharge, consult and operative reports, imaging reports, lab results, medication use, and family history of their patient.

EpicCare Link users can also receive correspondence and messages from Texas Children’s physicians and can view and receive notifications about inpatient admissions, discharges, emergency room encounters, urgent care visits, and view upcoming appointments at the touch of a button.

For more information on EpicCare Link, click here.

 

While on a recent family vacation, Jeanette McMullen shares the magic of Disney World and how our patients and families can relive this magical experience at Texas Children’s thanks to our Disney partnership. More

This month’s episode of Medically Speaking features Texas Children’s Chief of Plastic Surgery Dr. Edward Buchanan speaking about Texas Children’s multidisciplinary approach to cleft lip and palate care. In his talk, Buchanan outlines the spectrum of cleft lip and palate presentations, from minor abnormalities to more severe structural issues. He also gives an overview of the steps along the patient’s and family’s therapy and treatment pathway, including:

  • Prenatal counseling and diagnosis
  • Best feeding practices
  • Primary repairs and secondary procedures
  • Final surgeries when the patient is 16 years or older

“Cleft lip and palate care at Texas Children’s is not fragmented,” says Buchanan. “This kind of care can’t be done effectively in a silo by just one person; it takes a team. Our experts follow the child through their entire care journey to make sure we’re optimizing outcomes and that we’re not missing any opportunities.”

Learn more about Texas Children’s expertise in our Cleft Lip and Palate Clinic and about the full suite of services provided by the Division of Plastic Surgery.

About Medically Speaking

Medically Speaking, a video series from Texas Children’s Service Line Marketing, features some of the brightest minds from several Texas Children’s specialty and subspecialty areas. The series is meant to be a helpful educational resource for parents and a convenient way for physicians and other caregivers to stay up-to-date on the latest in pediatric medicine. Viewers can watch talks on a variety of interesting topics, including advancements in surgery, breakthroughs in research, new clinical trials, and novel and back-practice treatments for specific conditions.

Don’t miss future Medically Speaking episodes featured here on Connect, or view additional episodes now.

PLEASE NOTE:
This presentation is not intended to present medical advice or individual treatment recommendations, and does not supplant the practitioner’s independent clinical judgment. Practitioners are advised to consider the management of each patient in view of the clinical information. All content is shared for informational purposes only, and reflects the thoughts and opinions of the original author. No physician-patient relationship is being created by the use of this presentation. The presentation sets out recommendations based upon similar circumstances and is provided as an educational tool. The presenters are not attorneys, and to the extent this presentation provides commentary on current laws and regulations affecting health care activities, it is not intended as legal advice.

Online and direct scheduling have become easier at Texas Children’s with the introduction of MyChart, an online patient portal application launched in 2018. To date, thousands of patients have used the free MyChart feature to schedule and manage their appointments, communicate with their doctor, access medical records, obtain lab results and request prescription refills. Learn more by visiting our 2018 virtual Annual Report.

On his blog this week, Mark Wallace honors his sweet, lively mother, Mollie Wallace, who gave him a lifetime of joy and love. More