Transitional care of biliary atresia.

Area of Science:

• Hepatology and Gastroenterology
• Pediatric Surgery
• Transplantation Medicine

Background:

• Biliary atresia affects young adults, with native liver survival rates ranging from 14% to 44%.
• Complications like cholangitis and portal hypertension are common, often necessitating liver transplantation in adulthood.
• Existing adult liver transplant criteria may not suit this population, leading to delays and health deterioration.

Purpose of the Study:

• To review the current understanding of biliary atresia in young adults surviving with their native liver.
• To highlight the unique challenges faced by this cohort, including growth, puberty, and neuro-cognitive development.
• To emphasize the need for specialized, multidisciplinary adult services for comprehensive care.

Main Methods:

• Literature review of studies focusing on young adults (>20 years) with biliary atresia and native liver survival.
• Analysis of data on complications, growth, puberty, neuro-cognitive development, and quality of life.
• Examination of current adult healthcare transition and service provision.

Main Results:

• Limited data exists on growth, puberty, and neuro-cognitive development in this population.
• Pregnancy poses significant risks for patients with advanced liver disease.
• Patients report lower health-related quality of life compared to healthy peers.

Conclusions:

• Young adults with biliary atresia require specialized, multidisciplinary care tailored to their specific needs.
• Transition from pediatric to adult services is challenging and requires improved coordination and professional awareness.
• Holistic care addressing medical, psychosocial, and developmental needs is essential for this cohort.