Division of Nephrology Resources

Description of Boston Children's Hospital and the Harvard Medical School Environment

Boston Children's Hospital is one of the largest pediatric hospitals in the United States, and a major teaching facility of Harvard Medical School. Founded in 1869 as a 20-bed hospital for children, it is now a comprehensive medical center for pediatric and adolescent health care, dedicated to excellence in patient care, teaching and research.

There are 377 inpatient beds in the Main hospital building and in the new, state-of-the-art clinical expansion building, which opened in July 2005. The hospital houses two multidisciplinary intensive care units (41 beds), a neonatal intensive care unit (28 beds), a cardiac intensive care unit (24 beds), a bone marrow transplantation unit (12 beds), and a clinical research center. There are more than 100 outpatient programs ranging from primary care to a wide variety of specialty programs.

Outpatient facilities include an 11-story building for ambulatory services, During the next 10 years, Children's plans to expand to almost 500 beds, adding another clinical building and an additional 21-story research building. The Hospital is the primary pediatric teaching hospital of Harvard Medical School, where our staff have faculty appointments. The hospital's clinical staff includes approximately 960 active medical staff and 897 residents and fellows. Boston Children's Hospital has repeatedly been rated as one of the best hospital specializing in pediatric care in the nation.

As a major pediatric referral center, Boston Children's Hospital's mission is to provide the highest quality health care. In support of this mission, Children's strives to be the leading source of research and discovery, seeking new approaches to the prevention, diagnosis and treatment of childhood diseases as well as to educate the next generation of leaders in child health. Boston Children's Hospital consistently receives the highest amount of NIH grant support among independent pediatric institutions in the USA, and ranks 5th for NIH grant support to all independent domestic hospitals.

The research infrastructure for pediatric research at Boston Children's Hospital is one of the largest in the world. Laboratory research at Boston Children's Hospital is conducted in two buildings. The Enders Research building, which consists of approximately 184,000 square feet of space and the Karp Building, a 16-story facility, which was completed in 2004. The Karp research building is a 140,000 square foot facility, and has increased the total laboratory research space at Boston Children's Hospital to approx. 324,000 square foot. Of this, the Department of Medicine occupies approx. 200,000 square feet. This has allowed the expansion of all of the research programs within the Department of Medicine. An additional new research building is planned for completion in 2010, which will add another 100,000 square foot of research space. These expansions have resulted in the recruitment of new faculty, which is likely to continue over the next decade.

Approx. 30,000 square foot of space is devoted to clinical research. This is in addition to the space occupied by our NIH-funded General Clinical Research Center (GCRC) devoted solely to pediatric investigation. The inpatient GCRC is an 8-bed unit centrally located within the main building of Children's Hospital and is organized to support the management of children participating in clinical research. Clinical research is also supported by the Clinical Research Program (CRP), which provides methodologic expertise to the clinical research community.

The research facilities at Boston Children's Hospital are situated in the center of the Longwood Medical Area where Harvard Medical School and 3 other major teaching hospitals including Brigham and Women's, Beth Israel Deaconess Medical Center, and Dana Farber Cancer Institute are located. The Hospital is within a block of the Joslin Diabetes Center, the Massachusetts College of Pharmacy, the Harvard School of Public Health, the Harvard Dental School, the Harvard Institutes of Medicine, the Channing Laboratory, and the Center for Blood Research Institute of Biomedical Research. We have taken advantage of our Division's location within this medical research area to provide a large number of educational opportunities for nephrology research trainees. We wish to emphasize that researchers at Boston Children's Hospital greatly benefit from their location within the Harvard Medical community, but at the same time it should be recognized that Boston Children's Hospital is a free-standing world renowned research institution.

Our Nephrology Division is one of 14 divisions of the Department of Medicine at Boston Children's Hospital. The Division consists of 15 faculty. This includes 15 full time members (Drs. Baum, Briscoe, Daouk, Ferguson, Frank, Guleria, Harmon, Herrin, Kreidberg, Pal, Fiorina, Rodig, Sayegh, Somers, Schachter), and 1 clinical associate (Dr. Krueger). Dr Harmon is the Director of Kidney Transplantation, Dr. Sayegh serves as director of the research laboratories, Dr. Briscoe serves as Training Program Director and Dr. Somers directs the clinical services. At present, there are 8 Pediatric Nephrology fellows and 18 post-doctoral research fellows receiving research training in the Division by our Faculty.


Clinical Resources and Environment

Drs. Harmon and Somers are principally responsible for the large number of clinical nephrology services offered by our Division. These services include a 7-bed pediatric dialysis unit providing acute and chronic hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT) for infants, children, and adolescents with acute and chronic renal failure. The unit performs approximately 5,000 extracorporeal treatments annually. The dialysis unit and its accompanying renal transplantation program comprise the End Stage Renal Disease (ESRD) Program that has a staff of 13 dialysis nurses, 2 renal transplant coordinators, 2 social workers, a dietitian, a full-time research nurse and data coordinator, and 2 secretaries. Patients treated by this program who require hospitalization are routinely admitted to a dedicated 10-bed inpatient Solid Organ Transplant Unit located on the tenth floor of Boston Children's Hospital. Dr. Harmon has developed most of the protocols used by the staff, who are specialized in the care of organ transplant recipients. The renal transplantation program performs approximately 20 renal transplants annually, and is among the larger pediatric renal transplant programs in the country. The clinical faculty of this program also provide specialized dialysis services in the two pediatric intensive care units (41 beds), the 24 bed cardiac intensive care unit, the 28 bed neonatal intensive care unit, and the 12 bed bone marrow transplant unit.

The outpatient care of the division is administered through 2 ambulatory programs. The General Renal Program has approximately 3200 patient visits annually. The Renal Transplant Ambulatory Program has approximately 1300 visits annually, for a total of approximately 4500 outpatient visits annually. These programs are staffed by 5 ambulatory nurse coordinators as well by our Division's professional and secretarial staff.

The nephrology office has 5 full time administrative staff and the research laboratory office has 2 administrative staff. In the research laboratories, every fellow has a personal computer, linked to the hospital wide electronic data network. At Boston Children's Hospital, all clinical information (including complete inpatient and outpatient medical records as well as laboratory data) is maintained in an integrated Electronic Medical Record. In addition, most medical journals are available in electronic form through a link with Harvard's Countway Medical Library. Thus, the hospital network provides fellows with immediate access to patient material, research literature, databases and other Internet-based systems. In addition, each fellow is given an electronic mail box and can communicate with all hospital personnel and outside collaborators via this medium.

Research Resources and Environment

Research Space: The Division of Nephrology Research Laboratories consists of 7,500 square feet of research space including 38 benches and core facilities- for tissue culture, molecular biology, protein assays, FACS analysis, immunohistochemistry and for radioactive work. Our research facilities and labororatories are housed on the 8th floor of the Ender's Research Building. The divisional research space also includes several storage rooms that contain refrigerators, freezers, and large centrifuges. The Transplantation Research Center (TRC), Directed by Dr Sayegh and a collaboration between our Division and the Brigham and Women's Hospital and Harvard University also has dedicated research space within our laboratories. The TRC has 6 Principal Investigators and their laboratories at the Children's Hospital location. In addition, over the next 5 years, as more space becomes available in the new research building (due to open in 2010), there are plans for the expansion of our research facility by an additional 3,000 square feet, and the recruitment of 1-2 additional investigators into our laboratories. Each principal investigator has a personal office. There are two office suites, one where Dr Kreidberg and his administrative assistant are located, and another where Drs Briscoe and Sayegh and two research administrative assistants are located.

Research Equipment: Over the past five years the Division of Nephrology has evolved into one of the major research divisions at Boston Children's Hospital. Each independent investigator has a well-equipped laboratory and independently acquires modern biomedical instrumentation as is necessary for their ongoing studies. As such, within the Division's laboratories, there is equipment for cell culture, immunological assays, cell biology, molecular biology, and developmental biology research. For the most part, investigators share such instrumentation on an as needed basis with each other.