Decreasing Rate of Biliary Atresia in Taiwan: A Survey, 2004–2009

Robert

Pediatric Transplantation

et al. 2015

Liver transplantation (LT) has considerably improved the outcome of patients with end-stage liver disease, especially in children. The first pediatric LT in Vietnam was performed in 2004. To assess the current need for pediatric LT in Southern Vietnam, a total of 280 patients with chronic liver disease followed at Children's Hospital 2 (Ho Chi Minh City), the only pediatric LT center in this region, were evaluated from January 2009 to June 2014. Sixty-seven patients satisfied criteria for LT but only one transplant surgery occurred since 2009. Parental consent for LT was obtained only in 28.4% of patients. The main reasons for the small number of LTs were financial costs, far distance from home, lifelong follow-up and treatment, and shortage of organ donors. We conclude that the current need for pediatric LT in Southern Vietnam is high. Efforts should be made to develop the liver transplant program in this developing country.

Section: Discussionsupporting

confidence: 57%

“…BA occurs in 0.25/10 000 live births in Europe , in 0.8/10 000 in New York City , and some studies report a higher prevalence in Asian countries . In a study performed in Taiwan, the incidence of BA was 0.8/10 000 live births from mothers from Southeast Asia, including Vietnam .…”

Section: Discussionmentioning

confidence: 99%

Current status and actual need for pediatric liver transplantation in Southern Vietnam

Robert

Pediatric Transplantation

et al. 2015

J of Gastro and Hepatol

“…The incidence of BA in the USA is about 0.73 per 10 000 live births with a slight female predominance . The incidence is lower in some European countries such as France (0.51 per 10 000) but higher in Asia, as in Taiwan (1.23 per 10 000) . Left untreated, BA is fatal; the only effective treatments are hepatic portoenterostomy (Kasai operation) and liver transplantation .…”

Section: Biliary Atresiamentioning

confidence: 99%

“…37 The incidence is lower in some European countries such as France (0.51 per 10 000) but higher in Asia, as in Taiwan (1.23 per 10 000). 38,39 Left untreated, BA is fatal; the only effective treatments are hepatic portoenterostomy (Kasai operation) and liver transplantation. 40 In children, BA is the most common cause of end-stage liver disease and the leading indication for liver transplantation.…”

Section: Biliary Atresiamentioning

confidence: 99%

Transitional care for patients with surgical pediatric hepatobiliary disease: Choledochal cysts and biliary atresia

Aspelund

Mahdi

Rothstein

et al. 2019

Choledochal cysts (CDCs) and biliary atresia (BA) are rare pediatric hepatobiliary anomalies that require surgical intervention due to increased risk of malignancy and liver failure, respectively. The underlying disease and operative procedures place patients at risk for long‐term complications, which may continue to affect them into adulthood. Lack of a transitional care model in the health‐care system potentiates the challenges they will face following aging out of their pediatric providers' care. We sought to elucidate the long‐term complications and challenges patients with CDCs and BA face, review the current literature regarding transitioning care, and propose guidelines aiding adult providers in continued care and surveillance of these patients. A literature review was performed to assess short‐term and long‐term complications after surgery and the current standards for transitioning care in patients with a history of CDCs and BA. While transitional programs exist for patients with other gastrointestinal diseases, there are few that focus on CDCs or BA. Generally, authors encourage medical record transmission from pediatric to adult providers, ensuring accuracy of information and compliance with treatment plans. Patients with CDCs are at risk for developing biliary malignancies, cholangitis, and anastomotic strictures after resection. Patients with BA develop progressive liver failure, necessitating transplantation. There are no consensus guidelines regarding timing of follow up for these patients. Based on the best available evidence, we propose a schema for long‐term surveillance.

Seminars in Pediatric Surgery

“…By comparison, Bobo et al[19] did not detect rotavirus (groups A, B or C) RNA from infant BA liver specimens or controls. A more recent study by Lin et al[20] found a significant decrease in the incidence of BA in Taiwan following introduction of a rotavirus vaccination. The authors proposed that although rotavirus vaccination is initiated at 2 months of age, later than the usual age of onset of BA, herd immunity might have decreases rotavirus infection during pregnancy or the neonatal period.…”

Section: Perinatal Virus Infection and Biliary Atresiamentioning

confidence: 99%

Biliary atresia: cellular dynamics and immune dysregulation

Feldman

Mack

2012

The cause of biliary atresia (BA) is unknown and in the past few decades the majority of investigations related to pathogenesis have centered on virus infections and immunity. The acquired or perinatal form of BA entails a progressive, inflammatory injury of bile ducts, leading to fibrosis and obliteration of both the extrahepatic and intrahepatic bile ducts. Theories of pathogenesis include viral infection, chronic inflammatory or autoimmune-mediated bile duct injury and abnormalities in bile duct development. This review will focus solely on human studies pertaining to a potential viral trigger of bile duct injury at diagnosis and provide insight into the interplay of the innate and adaptive immune responses in the pathogenesis of disease.