학술논문

Progressive familial intrahepatic cholestasis—outcome and time to transplant after biliary diversion according to genetic subtypes
Document Type
article
Source
Frontiers in Surgery, Vol 10 (2023)
Subject
biliary diversion
morbus byler
pediatric liver transplantation (pediatric LT)
progressive familial intrahepatic cholestasis (PFIC)
pediatric surgery
liver disease
Surgery
RD1-811
Language
English
ISSN
2296-875X
Abstract
BackgroundProgressive familial intrahepatic cholestasis (PFIC) is a heterogeneous disease characterized by progressive cholestasis in early childhood. Surgical therapy aims at preventing bile absorption either by external or internal biliary diversion (BD). Several different genetic subtypes encode for defects in bile transport proteins, and new subtypes are being discovered ongoingly. Overall, the literature is scarce, however, accumulating evidence points to PFIC 2 having a more aggressive course and to respond less favorable to BD. With this knowledge, we aimed to retrospectively analyze the long-term outcome of PFIC 2 compared to PFIC 1 following BD in children at our center.MethodsClinical data and laboratory findings of all children with PFIC, who were treated and managed in our hospital between 1993 and 2022, were analyzed retrospectively.ResultsOverall, we treated 40 children with PFIC 1 (n = 10), PFIC 2 (n = 20) and PFIC 3 (n = 10). Biliary diversion was performed in 13 children (PFIC 1, n = 6 and 2, n = 7). Following BD, bile acids (BA) (p = 0.0002), cholesterol (p