1. Beyond the Pediatric end-stage liver disease system: solutions for infants with biliary atresia requiring liver transplant.
- Author
-
Tessier ME, Harpavat S, Shepherd RW, Hiremath GS, Brandt ML, Fisher A, and Goss JA
- Subjects
- Age Factors, Biliary Atresia diagnosis, Biliary Atresia mortality, End Stage Liver Disease diagnosis, End Stage Liver Disease mortality, Humans, Infant, Risk Factors, Time-to-Treatment, Tissue Donors supply & distribution, Treatment Outcome, Waiting Lists, Biliary Atresia surgery, Decision Support Techniques, End Stage Liver Disease surgery, Liver Transplantation adverse effects, Liver Transplantation methods, Liver Transplantation mortality, Portoenterostomy, Hepatic adverse effects, Portoenterostomy, Hepatic mortality
- Abstract
Biliary atresia (BA), a chronic progressive cholestatic disease of infants, is the leading cause for liver transplant in children, especially in patients under two years of age. BA can be successfully treated with the Kasai portoenterostomy; however most patients still require a liver transplant, with up to one half of BA children needing a transplant by age two. In the current pediatric end-stage liver disease system, children with BA face the risk of not receiving a liver in a safe and timely manner. In this review, we discuss a number of possible solutions to help these children. We focus on two general approaches: (1) preventing/delaying need for transplantation, by optimizing the success of the Kasai operation; and (2) expediting transplantation when needed, by performing techniques other than the standard deceased-donor, whole, ABO-matched organ transplant.
- Published
- 2014
- Full Text
- View/download PDF