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Noelle Ebel, MD

  • Noelle Hanako Ebel

Like a child, the liver is resilient. My foremost goal, as a highly specialized doctor, is to improve the lives of children with liver disease by providing expert care and making meaningful contributions in both research and clinical practice. It is a privilege to return children with liver disease to their best possible health.

Specialties

Gastroenterology

Work and Education

Professional Education

Boston University School of Medicine Office of the Registrar, Boston, MA, 5/1/2011

Residency

UCSF Pediatric Residency, San Francisco, CA, 06/30/2014

Fellowship

Seattle Children's Hospital Pediatric Gastroenterology Fellowship, Seattle, WA, 06/30/2017

UCSF Pediatric Transplant Hepatology, San Francisco, CA, 07/06/2018

Board Certifications

Pediatric Gastroenterology, American Board of Pediatrics

Pediatrics, American Board of Pediatrics

Transplant Hepatology, American Board of Pediatrics

All Publications

Hepatic Venous Pressure Gradient Measurements in Children: Correlation With Hepatic Histology and Clinical Indicators of Portal Hypertension. Journal of pediatric gastroenterology and nutrition Ebel, N. H., Carlin, K., Shaffer, M. L., Shivaram, G., Hawkins, M., Lane, E. R., Cooper, K., Lindquester, W. S., Gadodia, G., Murray, K. F. 2019; 68 (6): 78892

Abstract

In adults, elevated hepatic venous pressure gradients (HVPGs) are correlated with the degree of liver fibrosis on histopathology and predict worse outcomes including variceal bleeding and death. We aimed to examine the association between HVPG measurements, histopathologic findings, and clinical indicators of portal hypertension in children.Utilizing retrospective data from 2 pediatric centers between 2006 and 2015, we identified children who underwent simultaneous HVPG measurement and transjugular liver biopsy. Medical charts were reviewed for histopathology, imaging, endoscopic, and clinical data.Forty-one children (median age 11 years) were included in the analysis with diagnoses of acute hepatitis (n=15), chronic liver disease (n=12), hepatic noncirrhotic portal hypertension (n=4), acute liver failure (n=3), and nonhepatic causes of portal hypertension (n=7). Elevated mean HVPG measurements were found in children with acute liver failure (10 mmHg, range 4-12) and chronic liver disease (7 mmHg, range 1-12). HVPG measurements did not correlate with the histological severity of fibrosis (=0.23, P=0.14) or portal inflammation (=0.24, P=0.29), and no difference was found in HVPG when comparing children with and without a history of variceal bleeding (P=0.43).HVPG measurements do not correlate significantly with the degree of hepatic fibrosis on biopsy. Furthermore, HVPG measurements are not associated with the presence of varices or history of variceal bleeding, suggesting the possibility of intrahepatic shunting in children with advanced liver disease. Therefore, unlike in adults, HVPG measurements may not accurately predict children who are at risk of complications from portal hypertension.

View details for DOI 10.1097/MPG.0000000000002327

View details for PubMedID 30921261

Editorial: an expert consensus for the management of chronic hepatitis B in Asian Americans. Alimentary pharmacology & therapeutics Ebel, N. H., Rosenthal, P. 2018; 47 (11): 154142

View details for DOI 10.1111/apt.14620

View details for PubMedID 29878412

Disparities in Waitlist and Posttransplantation Outcomes in Liver Transplant Registrants and Recipients Aged 18 to 24 Years: Analysis of the UNOS Database. Transplantation Ebel, N. H., Hsu, E. K., Berry, K., Horslen, S. P., Ioannou, G. N. 2017; 101 (7): 161627

Abstract

We evaluated liver transplantation waitlist and posttransplantation outcomes in those aged 18 to 24 years compared with both younger (0-17 years) and older (25-34 years) registrants and recipients.Using national data from the United Network for Organ Sharing, competing risk, Cox regression and Kaplan-Meier analyses were performed on first-time liver transplant registrants (n = 13 979) and recipients (n = 8718) ages 0 to 34 years between 2002 and 2015.Nonstatus 1A registrants, registrants aged 0 to 17 and 25 to 34 years were less likely to experience dropout from the waiting list compared with those aged 18 to 24 years (adjusted hazard ratio, 0-5 years = 0.36; 6-11 = 0.29; 12-17 = 0.48; 18-24 = 1.00; 25-34 = 0.82). Although there was no difference in risk of graft failure across all age groups, both younger and older age groups had significantly lower risk of posttransplant mortality compared with those aged 18 to 24 years (adjusted hazard ratio, for 0-5 years = 0.53, 6-11 = 0.48, 12-17 = 0.70, 18-24 = 1.00, 25-34 = 0.77). This may be related to lower likelihood of retransplantation after graft failure in those aged 18 to 24 years.This national registry study demonstrates for the first time poorer waitlist and postliver transplant outcomes in young adults ages 18 to 24 years at the time of listing and transplantation compared to older and younger age groups. Given the potential survival benefit in transplanting young adults and the shortage of solid organs for transplant, future studies are critical to identify and target modifiable risk factors to improve waitlist and long-term posttransplant outcomes in 18- to 24-year-old registrants and recipients.

View details for DOI 10.1097/TP.0000000000001689

View details for PubMedID 28230640

View details for PubMedCentralID PMC5481466