Agostino Pierro Returns to Sick Kids
Agostino Pierro has returned to the Hospital for Sick
Children as Chief of Pediatric General and Thoracic
Surgery, 25 years after completing a research fellowship
there from 1986 to 1988. He is associate editor of peer
review journals such as Journal of Pediatric Surgery,
Pediatric Surgery International, and European Journal
of Pediatric Surgery. He has published 307 peer reviewed
articles and has an average research funding in the last 7
years of approximately $1.5M per year.
Agostino’s research focuses on necrotizing enterocolitis
(NEC). The 40%-50% mortality rate is unabated
over the last 20 years. He feels that improving the outcome
in NEC could be a great contribution. He has
a program project grant application to CIHR for a 7
year team study comprising investigators in Toronto, in
London, U.K. and some in the United States.
“There are three pillars to this project: First is the basic
science component with high level scientists here, especially
Tai – Hee Kim, newly recruited from Harvard, and
CC Hung. Both are molecular biologists with a focus
on stem cells, the main thrust of this pillar. The second
pillar translation research is a clinical trial based on earlier
work in London, particularly the use of hypothermia to
cool the babies with NEC in order to abate the inflammation.
This has never been tested in babies with NEC,
though feasibility testing has been undertaken. The third
pillar is the organization of a consortium of the three level
3 neonatal intensive care units in Toronto, a great opportunity
for studies. Rapid response is required to deal
with NEC, but the usual response is too late, because of
the transport of children to the level 3 center. Like the
immediate treatment of strokes and myocardial infarctions,
there is a golden period that allows the intervention
to achieve the best results.”
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Agostino is also planning a randomized controlled
trial of antibiotics versus surgery in appendicitis. The
trial will involve 14 centres, 7 in Canada, 4 in the United
States, and three in Europe. This trial may change treatment,
or at least will define the subgroup that can be
spared an operation. Research themes that will be important
for Agostino are the use of stem cells as recovery
treatment in acute intestinal injury. The second stem cell
theme will be building intestine by adding stem cells to
a decellularized scaffold. This is an important and relatively
undeveloped new area for research.
Agostino began his medical and surgical training in
Rome. Then he came to Toronto for a research fellowship
at the Hospital for Sick Children, and subsequently
took a staff position in London where he has been at
University College London on Great Ormond Street for
19 years.
His family includes Dominique, his Belgian wife,
who has worked for the United Nations as a fund raiser
for the UN’s food and agricultural programs as well
as a fund raiser for Great Ormond Street. Together,
they have adopted three children: 21 year old Leon is
at the University of Bristol, UK, Lauryn is at De La
Salle College in Toronto, and Lia at Forest Hill School.
Agostino operates two days per week, spends one day
per week on administrative work, and one and a half
days per week on research. His surgical work is primarily
minimally invasive surgery, which is expanding even
in neonates. For example, tracheoesophageal fistulas
and Bochdalek hernias as well as pyloromyotomies are
now treated using minimally invasive techniques. He
has developed the technique for pancreatic resection for
hyperinsulinism using minimally invasive techniques,
but needs a PET scan to continue this work in Toronto.
M.M.
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