Overview

My research is focused on children who have lost a significant amount of their intestine or whose intestines do not function properly. Often these children have difficulty gaining weight and reaching their growth potential. I am interested in determining how changes to the community gut bacteria in these children can impact their growth and metabolism. Ultimately, I want to find treatments to restore a healthy balance of gut bacteria in these children in order to improve intestinal function, overall nutrition, and growth. I am also interested in determining how changes to the gut bacteria impact the body's immune system and overall level of inflammation potentially predisposing children with intestinal failure to infection, liver disease, and blood clots.

Publications

Standardizing vitamin D supplementation to minimize deficiency in children with intestinal failure
Nutrition in Clinical Practice
DOI: 10.1002/ncp.11094
2024

The Effect of Nutrient Deprivation on Early Life Small Intestinal Mucosal Microbiome and Host Proteome
Journal of Nutrition
DOI: 10.1016/j.tjnut.2023.12.020
2024

Risk Factors for Infection in Neonates With Intestinal Failure
Journal of Pediatric Surgery
DOI: 10.1016/j.jpedsurg.2024.01.019
2024

Intestinal microbial and metabolite profile in infants with small bowel stomas after bowel resection
Journal of Pediatric Gastroenterology and Nutrition
DOI: 10.1002/jpn3.12327
2024

Treatment and Outcomes of Congenital Ovarian Cysts A Study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)
Annals of Surgery
DOI: 10.1097/SLA.0000000000005409
2023

Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group
Journal of Pediatric Surgery
DOI: 10.1016/j.jpedsurg.2023.01.018
2023

Nutrition considerations in pediatric surgical patients
Nutrition in Clinical Practice
Debby S. Martins and Hannah G. Piper
DOI: 10.1002/ncp.10855
06/2022

The Importance of the ileocecal valve and colon in achieving intestinal independence in infants with short bowel syndrome
Journal of Pediatric Surgery
Peters, F.B. and Bone, J.N. and Van Oerle, R. and Albersheim, S. and Casey, L. and Piper, H.
DOI: 10.1016/j.jpedsurg.2021.09.028
2022

Urine sodium to urine creatinine ratio as a marker of total body sodium in infants with intestinal failure
Journal of Pediatric Surgery
Choi, S. and Casey, L. and Albersheim, S. and Van Oerle, R. and Irvine, M.A. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2021.12.035
2022

Differentiating congenital ovarian cysts from other abdominal cystic lesions in female infants: A study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)
Journal of Pediatric Surgery
Safa, N. and Yanchar, N. and Puligandla, P. and Sewitch, M. and Baird, R. and Beaunoyer, M. and Butter, A. and Campbell, N. and Chadha, R. and Griffiths, C. and Jones, S. and Kaur, M. and Le-Nguyen, A. and Nasr, A. and Piché, N. and Piper, H. and Prasil, P. and Romao, R. and VanHouwelingen, L. and Wales, P. and Guadagno, E. and Emil, S. and for the Canadian Consortium for Research in Pediatric Surgery (CanCORPS)
DOI: 10.1016/j.jpedsurg.2021.12.043
2022

NeoCHIRP: A model for intestinal rehabilitation in the neonatal intensive care unit
Nutrition in Clinical Practice
Linda M. Casey and Jaclyn Strauss and Keerat K. Dhaliwal and Sonia Butterworth and Hannah G. Piper and Susan G. Albersheim
DOI: 10.1002/ncp.10734
12/2021

Use of instructional videos to reduce central venous catheter complications in children with intestinal failure receiving home parenteral nutrition
Nutrition in Clinical Practice
August Pierik and Debby S. Martins and Linda Casey and Hannah G. Piper
DOI: 10.1002/ncp.10638
08/2021

The effect of daily probiotics on the incidence and severity of necrotizing enterocolitis in infants with very low birth weight
Canadian Journal of Surgery
Que, J. and Van Oerle, R. and Albersheim, S. and Panczuk, J. and Piper, H.
DOI: 10.1503/cjs.016920
2021

Enteral Nutrition in Pediatric Short-Bowel Syndrome.
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Channabasappa N and Girouard S and Nguyen V and Piper H
DOI: 10.1002/ncp.10565
PubMed: 32815247
08/2020

The Impact of Lactobacillus Probiotics on the Gut Microbiota in Children With Short Bowel Syndrome
Journal of Surgical Research
Piper, H.G. and Coughlin, L.A. and Hussain, S. and Nguyen, V. and Channabasappa, N. and Koh, A.Y.
DOI: 10.1016/j.jss.2020.01.024
2020

A comparison of small bowel and fecal microbiota in children with short bowel syndrome
Journal of Pediatric Surgery
Piper, H.G. and Coughlin, L.A. and Nguyen, V. and Channabasappa, N. and Koh, A.Y.
DOI: 10.1016/j.jpedsurg.2020.01.032
2020

A Comparison of Smoflipid® and Intralipid® in the Early Management of Infants with Intestinal Failure
Journal of Pediatric Surgery
Casson, C. and Nguyen, V. and Nayak, P. and Channabasappa, N. and Berris, K. and Panczuk, J. and Bhiladvala, C. and Dasgupta, T. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2019.09.073
2020

Access to Paid Parental Leave for Academic Surgeons
Journal of Surgical Research
Itum, D.S. and Oltmann, S.C. and Choti, M.A. and Piper, H.G.
DOI: 10.1016/j.jss.2018.01.001
2019

A large prenatally undiagnosed mass in a preterm infant, what could it be?
NeoReviews
Ibrahim, J. and Pavageau, L. and Miller, J. and Timmons, C.F. and Wickiser, J.E. and Piper, H. and Dariya, V. and Brion, L.P.
DOI: 10.1542/neo.19-7-e413
2018

Intestinal microbiota in short bowel syndrome
Seminars in Pediatric Surgery
Piper, H.G.
DOI: 10.1053/j.sempedsurg.2018.07.007
2018

Pediatric breast masses: an argument for observation
Journal of Surgical Research
McLaughlin, C.M. and Gonzalez-Hernandez, J. and Bennett, M. and Piper, H.G.
DOI: 10.1016/j.jss.2018.03.056
2018

Growth Trajectory in Children with Short Bowel Syndrome during the First 2 Years of Life
Journal of Pediatric Gastroenterology and Nutrition
McLaughlin, C.M. and Channabasappa, N. and Pace, J. and Nguyen, H. and Piper, H.G.
DOI: 10.1097/MPG.0000000000001762
2018

Anticoagulation results in increased line salvage for children with intestinal failure and central venous thrombosis
Journal of Pediatric Surgery
McLaughlin, C.M. and Bennett, M. and Channabasappa, N. and Journeycake, J. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2018.02.007
2018

A comparison of lipid minimization strategies in children with intestinal failure
Journal of Pediatric Surgery
Gonzalez-Hernandez, J. and Prajapati, P. and Ogola, G. and Nguyen, V. and Channabasappa, N. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2017.10.030
2018

Caregiver Education Reduces the Incidence of Community-Acquired CLABSIs in the Pediatric Patient with Intestinal Failure
Gastroenterology Nursing
Drews, B. and Macaluso, M. and Piper, H. and Channabasappa, N.
DOI: 10.1097/SGA.0000000000000274
2017

A comparison of Broviac® and peripherally inserted central catheters in children with intestinal failure
Journal of Pediatric Surgery
Blotte, C. and Styers, J. and Zhu, H. and Channabasappa, N. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2017.01.036
2017

Severe Gut Microbiota Dysbiosis Is Associated with Poor Growth in Patients with Short Bowel Syndrome
Journal of Parenteral and Enteral Nutrition
Piper, H.G. and Fan, D. and Coughlin, L.A. and Ho, E.X. and McDaniel, M.M. and Channabasappa, N. and Kim, J. and Kim, M. and Zhan, X. and Xie, Y. and Koh, A.Y.
DOI: 10.1177/0148607116658762
2017

Predicting time to full enteral nutrition in children after significant bowel resection
Journal of Pediatric Surgery
Gonzalez-Hernandez, J. and Prajapati, P. and Ogola, G. and Channabasappa, N. and Drews, B. and Piper, H.G.
DOI: 10.1016/j.jpedsurg.2017.01.038
2017

Endoscopic button gastrostomy: Comparing a sutured endoscopic approach to the current techniques
Journal of Pediatric Surgery
DOI: 10.1016/j.jpedsurg.2015.10.014
2016

Recent advances in the management of pediatric short bowel syndrome: An integrative review of the literature
Current Surgery Reports
Saeman, M.R. and Piper, H.G.
DOI: 10.1007/s40137-015-0126-x
2016

Central venous thrombosis in children with intestinal failure on long-term parenteral nutrition
Journal of Pediatric Surgery
DOI: 10.1016/j.jpedsurg.2016.02.024
2016

Intestinal neuronal dysplasia-like submucosal ganglion cell hyperplasia at the proximal margins of hirschsprung disease resections
Pediatric and Developmental Pathology
Swaminathan, M. and Oron, A.P. and Chatterjee, S. and Piper, H. and Cope-Yokoyama, S. and Chakravarti, A. and Kapur, R.P.
DOI: 10.2350/15-07-1675-OA.1
2015

Use of ethanol lock therapy for children with intestinal failure on long-term parenteral nutrition
Diet and Nutrition in Critical Care
DOI: 10.1007/978-1-4614-7836-2_133
2015

Delayed primary serial transverse enteroplasty as a novel management strategy for infants with congenital ultra-short bowel syndrome
Journal of Pediatric Surgery
DOI: 10.1016/j.jpedsurg.2013.02.015
2013

Prevention of catheter-related blood stream infections in children with intestinal failure
Current Opinion in Gastroenterology
Piper, H.G. and Wales, P.W.
DOI: 10.1097/MOG.0b013e328358e268
2013

Single-incision laparoscopic surgery in children: A randomized control trial of acute appendicitis
Surgical Endoscopy
Perez, E.A. and Piper, H. and Burkhalter, L.S. and Fischer, A.C.
DOI: 10.1007/s00464-012-2617-5
2013

NOTES suction grasper for tubular viscera - Characterization of gripping force when varying hole size, diameter, and number
Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
Brooks, R.J. and Piper, H. and Looi, T. and Drake, J.
DOI: 10.1109/EMBC.2013.6610603
2013

Peripherally inserted central catheters for long-term parenteral nutrition in infants with intestinal failure
Journal of Pediatric Gastroenterology and Nutrition
Piper, H.G. and De Silva, N.T. and Amaral, J.G. and Avitzur, Y. and Wales, P.W.
DOI: 10.1097/MPG.0b013e3182801e7b
2013

Childhood Diseases of the Thyroid and Parathyroid Glands
Pediatric Surgery
DOI: 10.1016/B978-0-323-07255-7.00058-1
2012

Ovarian torsion: Diagnosis of inclusion mandates earlier intervention
Journal of Pediatric Surgery
Piper, H.G. and Oltmann, S.C. and Xu, L. and Adusumilli, S. and Fischer, A.C.
DOI: 10.1016/j.jpedsurg.2012.06.011
2012

Use of a continuous glucose sensor in an extracorporeal life support circuit
Journal of Diabetes Science and Technology
Steil, G.M. and Alexander, J. and Papas, A. and Langer, M. and Modi, B.P. and Piper, H. and Jaksic, T. and Gottlieb, R. and Agus, M.S.D.
DOI: 10.1177/193229681100500113
2011

Gracilis transposition flap for repair of an acquired rectovaginal fistula in a pediatric patient
Journal of Pediatric Surgery
Piper, H.G. and Trussler, A. and Schindel, D.
DOI: 10.1016/j.jpedsurg.2011.05.004
2011

Is it necessary to drain all postoperative fluid collections after appendectomy for perforated appendicitis?
Journal of Pediatric Surgery
Piper, H.G. and Derinkuyu, B. and Koral, K. and Perez, E.A. and Murphy, J.T.
DOI: 10.1016/j.jpedsurg.2011.03.043
2011

Detection and management of hypothyroidism following thyroid lobectomy: Evaluation of a clinical algorithm
Annals of Surgical Oncology
Johner, A. and Griffith, O.L. and Walker, B. and Wood, L. and Piper, H. and Wilkins, G. and Baliski, C. and Jones, S.J.M. and Wiseman, S.M.
DOI: 10.1245/s10434-011-1627-1
2011

Intestinal atresias: factors affecting clinical outcomes
Journal of Pediatric Surgery
Piper, H.G. and Alesbury, J. and Waterford, S.D. and Zurakowski, D. and Jaksic, T.
DOI: 10.1016/j.jpedsurg.2007.09.053
2008

Current management of appendicitis at a community center-how can we improve?
American Journal of Surgery
Piper, H.G. and Rusnak, C. and Orrom, W. and Hayashi, A. and Cunningham, J.
DOI: 10.1016/j.amjsurg.2007.12.033
2008

First Report of the International Serial Transverse Enteroplasty Data Registry: Indications, Efficacy, and Complications
Journal of the American College of Surgeons
Modi, B.P. and Javid, P.J. and Jaksic, T. and Piper, H. and Langer, M. and Duggan, C. and Kamin, D. and Kim, H.B.
DOI: 10.1016/j.jamcollsurg.2006.12.033
2007

Nutrition and Wound Healing at the Age Extremes
Nutrition and Wound Healing
Hannah Piper and Tom Jaksic and Patrick Javid
DOI: 10.1201/9780203500231-18
10/2006

Growth and Nutritional Status in Infants With Short-Bowel Syndrome After the Serial Transverse Enteroplasty Procedure
Clinical Gastroenterology and Hepatology
Duggan, C. and Piper, H. and Javid, P.J. and Valim, C. and Collier, S. and Kim, H.B. and Jaksic, T.
DOI: 10.1016/j.cgh.2006.06.006
2006

The second STEP: the feasibility of repeat serial transverse enteroplasty
Journal of Pediatric Surgery
Piper, H. and Modi, B.P. and Kim, H.B. and Fauza, D. and Glickman, J. and Jaksic, T.
DOI: 10.1016/j.jpedsurg.2006.08.015
2006

Real-time continuous glucose monitoring in pediatric patients during and after cardiac surgery
Pediatrics
Piper, H.G. and Alexander, J.L. and Shukla, A. and Pigula, F. and Costello, J.M. and Laussen, P.C. and Jaksic, T. and Agus, M.S.D.
DOI: 10.1542/peds.2006-0347
2006

The impact of prenatal bowel dilation on clinical outcomes in neonates with gastroschisis
Journal of Pediatric Surgery
Piper, H.G. and Jaksic, T.
DOI: 10.1016/j.jpedsurg.2006.01.005
2006

The effect of insulin infusion upon protein metabolism in neonates on extracorporeal life support
Annals of Surgery
Agus, M.S.D. and Javid, P.J. and Piper, H.G. and Wypij, D. and Duggan, C.P. and Ryan, D.P. and Jaksic, T.
DOI: 10.1097/01.sla.0000237758.93186.c8
2006

Burns, Trauma and Critical Care
Manual of Pediatric Nutrition, 4th edition
2005

Detecting and defining hypothyroidism after hemithyroidectomy
American Journal of Surgery
Piper, H.G. and Bugis, S.P. and Wilkins, G.E. and Walker, B.A.M. and Wiseman, S. and Baliski, C.R. and Swartz, K.
DOI: 10.1016/j.amjsurg.2005.01.038
2005

Models for antigen receptor gene rearrangement. II. Multiple rearrangement in the TCR: Allelic exclusion or inclusion?
Journal of Immunology
Piper, H. and Litwin, S. and Mehr, R.
1999

Research

Current Projects
I am currently conducting a study investigating the use of probiotics as a means to predictably alter the gut microbiota in children with intestinal failure and poor growth. It is unclear whether taking oral probiotics is an effective way to restore balance to the gut bacteria given that many of these patients have rapid intestinal transit and difficulty with absorption. Ultimately, if probiotics prove efficacious, a larger study can be performed to determine the type and duration of therapy that would be most effective.

I am also involved in a study looking at how the gut microbiota contribute to inflammation in the liver of children with intestinal failure who are dependent on intravenous nutrition (parenteral nutrition). It is well known that some children on prolonged parenteral nutrition develop significant hepatic cholestasis and inflammation but the exact etiology of this is not completely understood. Episodes of sepsis, prematurity, the lack of enteral nutrition, and certain components of the parenteral nutrition are all thought to contribute. Recently, there has been evidence to suggest that the intestinal microbiota may also contribute to hepatic inflammation. In this study, I am trying to correlate the abundance of certain species of intestinal bacteria with abnormal hepatic metabolism of propionate (a short chain fatty acid) in children with short bowel syndrome.

Another study I am participating in involves determining if children with short bowel syndrome are predisposed to central venous thrombosis. These children frequently require long-term parenteral nutrition necessitating a functional central venous catheter. Unfortunately, they seem to have an increased incidence of central venous thrombosis compared to other patient groups. A preliminary study that I conducted identified a high incidence of acquired thrombophilia in these children due likely to both systemic inflammation and underlying compromised liver function. I am currently studying the best way to prevent venous thrombosis in these patients including screening and potential anticoagulation.

Grants

"Targeted probiotic therapy to improve the gut microbiota and growth in children with short bowel syndrome"; ASPEN Rhoads Foundation Grant; 1/2017- 1/2018.

"Role of intestial microbiota in children with intestinal failure and bacterial overgrowth"; APSA Foundation Grant; 7/2014- 7/2015.

"The role of the intestinal microbiota in the development of cholestatic liver disease in infants with short bowel syndrome"; Discovery Fund Grant; 1/2016- 1/2017.

Honours & Awards

Gut Microbiota Dysbiosis is Associated with Poor Growth in Children with Show Bowel Syndrome; 2015- 2017.

Provider of the Month Award for the provider who best fulfills the hospital mission; Children's Medical Center, Dallas, Texas; 2016.

Poster with Distinction, International Pediatric Intestinal Failure and Rehabilitation Symposium; 2016.