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Agostino Pierro Returns to Sick Kids


Agostino Pierro

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.”

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.


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