Rima Fawaz, MD
Associate Professor of Pediatrics (Gastroenterology & Hepatology)Cards
About
Research
Publications
2025
Recent advances in the management of pediatric cholestatic liver diseases
Mysore K, Cheng K, Suri L, Fawaz R, Mavis A, Kogan‐Liberman D, Mohammad S, Taylor S. Recent advances in the management of pediatric cholestatic liver diseases. Journal Of Pediatric Gastroenterology And Nutrition 2025 PMID: 39840645, DOI: 10.1002/jpn3.12462.Peer-Reviewed Original ResearchPediatric cholestatic liver diseasesCholestatic liver diseaseIleal bile acid transporterAlagille syndromeSlow disease progressionLiver diseaseBile acid transporterMedical therapyIleal bile acid transporter inhibitorClinical trialsDisease progressionProgressive familial intrahepatic cholestasisFamilial intrahepatic cholestasisPediatric liver transplantationBile acid toxicityCurative medical therapyAcid transportImprove patient qualityIntrahepatic cholestasisBiliary atresiaSurgical managementRare conditionLiver transplantationNutritional supportUnderlying etiology
2024
Pharmacological management of pediatric metabolic dysfunction‐associated steatotic liver disease
Jaoudeh R, Hartmann P, Olson O, Gupta O, Kumar S, Ibrahim S, Fawaz R, Aqul A, Hassan S. Pharmacological management of pediatric metabolic dysfunction‐associated steatotic liver disease. Journal Of Pediatric Gastroenterology And Nutrition 2024 PMID: 39526564, DOI: 10.1002/jpn3.12402.Peer-Reviewed Original ResearchGLP-1RABody mass indexLiver diseasePediatric patientsPediatric obesityEfficacy of GLP-1RADisease progressionGlucagon-like peptide-1 receptor agonistsSteatotic liver diseaseManagement of pediatric patientsPeptide-1 receptor agonistsClinical management of pediatric patientsAdverse liver outcomesInduce weight lossLong-term efficacyHepatic manifestation of obesityLiver enzyme levelsAlternative therapeutic strategiesHalting disease progressionManifestation of obesityNonalcoholic fatty liver diseaseChildhood obesity ratesFatty liver diseaseReceptor agonistsLiver transplantation
2023
Food Insecurity and Pediatric Nonalcoholic Fatty Liver Disease Severity
Orkin S, Zhao X, Setchell K, Carr E, Arce-Clachar A, Bramlage K, Huang R, Fei L, Beck A, Fawaz R, Valentino P, Xanthakos S, Mouzaki M. Food Insecurity and Pediatric Nonalcoholic Fatty Liver Disease Severity. The Journal Of Pediatrics 2023, 265: 113818. PMID: 37931698, PMCID: PMC11108653, DOI: 10.1016/j.jpeds.2023.113818.Peer-Reviewed Original ResearchNonalcoholic fatty liver diseaseHousehold Food Security Survey ModuleFood Security Survey ModuleNonalcoholic fatty liver disease severityPediatric nonalcoholic fatty liver diseasePossible pathophysiologic linkLiver disease severityFatty liver diseaseBMI z-scoreCross-sectional studyFood-secure counterpartsYears of ageSurvey ModulePathophysiologic linkWarrants further explorationHistologic severityLiver diseasePathophysiologic mechanismsFood insecurityMean ageFood insecurity statusEarly presentationDisease severityZ-scorePatientsA quality improvement intervention to decrease the decline in renal function in pediatric liver transplant recipients
Batsis I, Elisofon S, Ferguson M, Jonas M, Kimball B, Lee C, Mitchell P, Fawaz R. A quality improvement intervention to decrease the decline in renal function in pediatric liver transplant recipients. Pediatric Transplantation 2023, 27: e14506. PMID: 36938904, DOI: 10.1111/petr.14506.Peer-Reviewed Original ResearchConceptsPrevalence of eGFRPost-intervention periodPediatric liver transplant recipientsYear post-LTLiver transplant recipientsChronic kidney diseasePost-LTTransplant recipientsSignificant non-modifiable risk factorNon-modifiable risk factorsChildren post-LTLong-term morbidityBlood pressure percentilesGlomerular filtration rateQuality improvement interventionsQuality improvement projectHospital dischargeRenal functionMonth 24Kidney diseaseFiltration rateRisk factorsInclusion criteriaQI interventionsMetabolic disorders
2022
Natural history of liver disease in a large international cohort of children with Alagille syndrome: Results from the GALA study
Vandriel S, Li L, She H, Wang J, Gilbert M, Jankowska I, Czubkowski P, Gliwicz‐Miedzińska D, Gonzales E, Jacquemin E, Bouligand J, Spinner N, Loomes K, Piccoli D, D'Antiga L, Nicastro E, Sokal É, Demaret T, Ebel N, Feinstein J, Fawaz R, Nastasio S, Lacaille F, Debray D, Arnell H, Fischler B, Siew S, Stormon M, Karpen S, Romero R, Kim K, Baek W, Hardikar W, Shankar S, Roberts A, Evans H, Jensen M, Kavan M, Sundaram S, Chaidez A, Karthikeyan P, Sanchez M, Cavalieri M, Verkade H, Lee W, Squires J, Hajinicolaou C, Lertudomphonwanit C, Fischer R, Larson‐Nath C, Mozer‐Glassberg Y, Arikan C, Lin H, Bernabeu J, Alam S, Kelly D, Carvalho E, Ferreira C, Indolfi G, Quiros‐Tejeira R, Bulut P, Calvo P, Önal Z, Valentino P, Desai D, Eshun J, Rogalidou M, Dezsőfi A, Wiecek S, Nebbia G, Pinto R, Wolters V, Tamara M, Zizzo A, Garcia J, Schwarz K, Beretta M, Sandahl T, Jimenez‐Rivera C, Kerkar N, Brecelj J, Mujawar Q, Rock N, Busoms C, Karnsakul W, Lurz E, Santos‐Silva E, Blondet N, Bujanda L, Shah U, Thompson R, Hansen B, Kamath B, Group T. Natural history of liver disease in a large international cohort of children with Alagille syndrome: Results from the GALA study. Hepatology 2022, 77: 512-529. PMID: 36036223, PMCID: PMC9869940, DOI: 10.1002/hep.32761.Peer-Reviewed Original ResearchConceptsNative liver survivalLarge international cohortAlagille syndromeInternational cohortNLS rateNative liverLiver diseaseMedian total bilirubin levelsEvent-free survival rateNatural historyEarly biochemical predictorsEvident portal hypertensionLiver-related eventsRisks of transplantationMulticenter retrospective studyTotal bilirubin levelsEvaluation of therapyMonths of ageGALA studyHepatic outcomesLiver survivalPortal hypertensionTertiary centerBilirubin levelsRetrospective studyAcute Hepatitis of Unknown Origin in Children: Early Observations from the 2022 Outbreak
Zhang LY, Huang LS, Yue YH, Fawaz R, Lim JK, Fan JG. Acute Hepatitis of Unknown Origin in Children: Early Observations from the 2022 Outbreak. Journal Of Clinical And Translational Hepatology 2022, 10: 522-530. PMID: 35836761, PMCID: PMC9240245, DOI: 10.14218/jcth.2022.00281.Peer-Reviewed Original ResearchAcute hepatitisSevere acute respiratory syndrome coronavirus 2Acute respiratory syndrome coronavirus 2Unknown originRespiratory syndrome coronavirus 2Serum aminotransaminase levelsAcute liver failureIU/LSyndrome coronavirus 2Immune cell activationAminotransaminase levelsGastrointestinal symptomsLiver transplantationLiver failureCoronavirus 2Healthy childrenNegative testCell activationHepatitisCOVID-19 pandemicChildrenRecent reportsEarlier observationsOutbreakCauseComparing Serum Matrix Metalloproteinase-7 in Parenteral Nutrition-Associated Liver Disease and Biliary Atresia
Salvi PS, Fawaz R, Cowles RA. Comparing Serum Matrix Metalloproteinase-7 in Parenteral Nutrition-Associated Liver Disease and Biliary Atresia. The Journal Of Pediatrics 2022, 249: 97-100. PMID: 35714967, DOI: 10.1016/j.jpeds.2022.06.014.Peer-Reviewed Original ResearchConceptsBiliary atresiaLiver diseaseParenteral nutrition-associated liver diseaseParenteral Nutrition–Associated Liver DiseaseMetalloproteinase-7Matrix metalloproteinase 7 levelsSerum matrix metalloproteinase-7Cross-sectional studyMatrix metalloproteinase-7Parenteral nutritionInvasive testingAtresiaInfantsDiseaseJaundice
2021
Liver Pathology, Including MOC31 Immunohistochemistry, in Congenital Tufting Enteropathy
Chen S, Goldsmith J, Fawaz R, Al-Ibraheemi A, Perez-Atayde A, Vargas S. Liver Pathology, Including MOC31 Immunohistochemistry, in Congenital Tufting Enteropathy. The American Journal Of Surgical Pathology 2021, 45: 1091-1097. PMID: 33756496, DOI: 10.1097/pas.0000000000001710.Peer-Reviewed Original ResearchConceptsCTE patientsCongenital tufting enteropathyParenteral nutritionBiliary epitheliumDuctular reactionLiver pathologyChronic hepatitis CHepatitis C patientsEpithelial cell adhesion moleculeLiver core biopsyIntestinal villous atrophyNormal brush borderClinicopathologic materialEpCAM-deficientCore biopsyTufting enteropathyC patientsEpCAM mutationsCell adhesion moleculesHepatitis CLiver biopsyMOC31Affected patientsLobular inflammationPathological findings75 Acute and Chronic Hepatitis
Fawaz R, Jonas M. 75 Acute and Chronic Hepatitis. 2021, 819-837.e6. DOI: 10.1016/b978-0-323-67293-1.00075-x.Peer-Reviewed Original ResearchChronic hepatitisLiver biopsyHepatocellular carcinomaHepatitis B virus infectionAcute hepatitis CChronic hepatitis BB virus infectionPerinatal transmission rateGrade of inflammationAutoimmune hepatitisJaundice 3Transplantation 2Hepatitis CHepatitis BClinical courseHepatitis ANonalcoholic steatohepatitisHistologic featuresPersistent elevationViremia levelsPrimary indicationInfection 5Hepatic damageFamily historyVirus infection
2019
Internal surgical drainage for bile lakes following hepatoportoenterostomy for biliary atresia
Dee E, Zendejas B, Fawaz R, Kim H. Internal surgical drainage for bile lakes following hepatoportoenterostomy for biliary atresia. Journal Of Pediatric Surgery Case Reports 2019, 43: 71-73. DOI: 10.1016/j.epsc.2019.02.015.Peer-Reviewed Original ResearchBile lakesBiliary atresiaBiliary cystic lesionsInternal surgical drainageResolution of jaundiceRecurrence of symptomsTime of diagnosisViable surgical optionCholangitis episodesPrevious portoenterostomyAntibiotic prophylaxisLiver transplantationRecurrent cholangitisSurgical drainagePercutaneous drainageRoux limbSurgical optionsCystic lesionsBile flowHepatoportoenterostomyPatientsCholangitisInternal drainageJaundiceCystjejunostomy
Clinical Trials
Current Trials
Wilson Disease Registry
HIC ID1609018429REGRoleSub InvestigatorPrimary Completion Date10/01/2022Recruiting ParticipantsGenderBothPrevalence of Carbohydrate Intolerance in Lean and Obese Children
HIC ID9909011190RoleSub InvestigatorPrimary Completion Date09/30/2025Recruiting ParticipantsGenderBothAge8 years - 18 years
Clinical Care
Overview
Rima Fawaz, MD, is the medical director of the Pediatric Liver Transplant Program and says the best part of her job is giving patients a new lease on life.
“It’s a happy field,” Dr. Fawaz says of transplant hepatology. “It’s truly the gift of life. In pediatric liver transplant, 60 to 70% of the causes are either inherited or something you are born with. Only a small fraction is something acquired, like from an infection. When we transplant, the outcomes are excellent with survival at 80% for patients 20 to 30 years later, which is astounding.”
Thanks to advances in anti-rejection medications, children who receive liver transplants today are able to live normal, healthy lives, Dr. Fawaz says. “Whereas it used to be about keeping them alive, now we are focused on long-term outcomes and finding the perfect balance of giving them just enough medication to prevent rejection, but also not harming any other organs from the medications,” she says.
In children, the main reason for liver transplant is biliary atresia, a congenital condition in which the bile ducts inside or outside of the liver do not develop properly. “This accounts for 40 to 50% of all liver transplants in pediatrics. The child cannot grow and life is so unhappy,” Dr. Fawaz says. “Then you transplant them, and you turn back time. Life returns. The kids typically do so well that we see them once or twice a year. It’s amazing.”
Dr. Fawaz is involved in several research efforts, including a study on acute liver failure funded by the National Institutes of Health.
Clinical Specialties
Fact Sheets
Polycystic Kidney Disease (PKD)
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Yale Medicine News
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News
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- May 12, 2022Source: Yale Medicine
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