Q&A with Dr. Amit A. Shah

Meet Amit A. Shah, MD, MSHP, a pediatric hepatologist with expertise in the evaluation and management of pediatric liver disease, including liver transplant. 

Amit A. Shah, MD, MSHP, is a hepatologist within the Fred and Suzanne Biesecker Pediatric Liver Center; a liver transplant physician with the Liver Transplant Program; and an attending physician within the Division of Gastroenterology, Hepatology and Nutrition at Children’s Hospital of Philadelphia. He is also an Assistant Professor of Clinical Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Dr. Shah has been repeatedly praised by patients and their families for his compassionate, effective and thorough patient care. He recently spent some time discussing his work and the field of pediatric liver disease.

Question: Why (and when) did you decide to specialize in working with children who have liver disorders?

Answer: The pathophysiology of liver disease has fascinated me ever since medical school after my internal medicine rotation on the adult hepatology service. As I settled on being a pediatrician as my career choice (there’s not a better feeling in the world than making a child feel better), my love for the liver never wavered. Thankfully, I was able to pursue my training at CHOP, where the liver team is truly top-notch. I have been able to learn – not only from amazing mentors, but also from all the children we take care of here on a day-to-day basis. It was an easy decision to complete my advanced hepatology fellowship at CHOP so I could continue taking care of children with liver disease.

Q: What are the challenges and rewards of working with children with liver disorders and their families? 

A: Working with children and their families is rewarding regardless of whatever ails them. The indescribable feeling of joy and compassion that overwhelms you once children with liver disease feel better makes it easy to come into work every day.  

However, liver disease is complex and potentially life-threatening, which can make the care for kids with liver disease quite challenging, especially as many kids are young and unable to directly communicate to you themselves. Many times, we – as pediatricians – must play detective and gather information from multiple sources, including families, to ensure we take the appropriate next steps in a child’s care.  

Q: What differentiates the Fred and Suzanne Biesecker Pediatric Liver Center, its subprograms and the Liver Transplant Program at CHOP from other pediatric liver programs in the country and around the world? 

A: I have been blessed to have started at CHOP for my training and now continue here as an attending physician. Above all else, the Liver Center, especially the Liver Transplant Program, sets itself apart because of the interdisciplinary team that truly puts patients and their families first. Our interdisciplinary team members are not only highly skilled but also dedicated, compassionate, and good listeners. The support we receive from the Liver Center and CHOP, allows us to do our best day-in and day-out to ensure we provide high value care to our patients. From basic science to clinical care at the bedside, the programs at CHOP span the continuum of pediatric liver disease allowing us to not only take care of individual patients, but also to further scientific advancement that will improve the lives of patients with liver disease worldwide.  

Q: What are your research interests? 

A: My research interests are mainly focused on decreasing the variation of care patients with liver disease receive and improving pre- and post-liver transplant outcomes for patients. We are also working on identifying opportunities for timely diagnosis and management of patients with liver disease, especially in those with biliary atresia and pediatric acute liver failure. These research endeavors will then drive quality improvement initiatives – not only at CHOP, but nationally – through organizations such as the Society of Pediatric Liver Transplantation (SPLIT).

Q: How do you translate your research knowledge into improved patient care for liver patients at CHOP?

A: Understanding the importance of quality improvement and implementation science is key to translating research into practice. Here at CHOP, our team is up to date on research advancements in the field. We use quality improvement methodology to improve processes and implement evidence-based practices with the goal of improving patient outcomes.

Q: How has your experience as a fellow with the Center for Healthcare Improvement and Patient Safety at the University of Pennsylvania guided or impacted your work with patients today at CHOP?

A: My experience with further training in quality improvement and patient safety impacts my work daily as it provides me with the framework to not only take care of my patients with liver disease, but to address the systemic issues that could potentially affect patient care.

The goal is to provide high-value care that is safe, effective, timely, efficient, equitable and patient-centered. My training has provided me the foundational knowledge and skills to make that happen to the best of our team’s ability: from completing quality improvement projects and conducting root cause analysis, to improving patient safety and advocating for our patients on a local and national scale.

Q: How have outcomes changed for patients with serious liver conditions in the past 20 years? What do you expect to change in the next 20?

A: Over the past 20 years, the field of liver disease has made great strides in diagnosis and management of liver disease. Research is providing new information – almost daily – on many different type of liver diseases. The use of genetics is becoming more prominent to help aid diagnosis and prognosis, while new medications (such as ileal bile acid transport inhibitors) have significantly improved quality of life for patients with cholestatic liver disease. And there is now a cure for hepatitis C.

The field of pediatric liver transplantation has made significant advances in surgical technique and immunosuppression management. Outcomes for patients undergoing liver transplant are now excellent. CHOP recently celebrated a milestone: it’s 500th pediatric liver transplant!

Still, as we look forward to the next 20 years, there is much more work to be done. Curing hepatitis C gives us hope for potential other cures in the future. With excellent liver transplant survival outcomes, we can now focus on the morbidity of transplantation and its management to improve patients’ quality of life. As the field advances, we will continue to make headway into precision medicine for pediatric liver disease and effectively use artificial intelligence in a variety of ways to provide clinical decision support and ultimately, to improve outcomes for patients and their families.

Q: What gives you hope for patients with liver disorders today … and in the years ahead?

A: Hope comes from every patient at CHOP, and their families. Children with liver disease are incredibly resilient. They compel us to continue to fight for them and their families. The pediatric liver community at CHOP is strong and continues to work tirelessly to advance the field – not only through research, but also through advocacy – to ensure the best outcomes for children with liver disease.

Q: Is there anything else you think patients or referring physicians should know about you and your approach to care?

A: At CHOP, we know it takes a village to take care of a child with liver disease. The importance of interdisciplinary care cannot be understated. Thankfully, we have the resources at CHOP to ensure our patients always come first, that their needs (both medical and psychosocial) are addressed, their families are supported and that we consistently provide high-value care.