Biliary Atresia Program

Faster diagnosis

Our Biliary Atresia Program has special expertise in quickly assessing babies who may have biliary atresia. At many hospitals, it can take several weeks to do all the tests to diagnose biliary atresia. Our team uses a blood test that looks at a molecule called MMP-7, which is specifically elevated in babies with biliary atresia.

This test gives us results in just two days, compared to two to three weeks for traditional testing. In addition, the MMP-7 test allows us to avoid doing an invasive liver biopsy. By eliminating the biopsy, we ensure that babies only need anesthesia once, for a procedure called a cholangiogram. This procedure is used to make a final diagnosis of biliary atresia. If the cholangiogram reveals biliary atresia, we go ahead and perform surgery while they are still sedated.

Optimizing treatments

The Kasai procedure is the most common treatment for biliary atresia. It involves removing the damaged bile duct and using tissue from the small intestine to create a new path for the bile. But about two thirds of babies continue to have blockages in their new bile ducts after the Kasai and will need a liver transplant.

Our team gives babies state-of-the-art care after the Kasai procedure to help them make a full recovery. We monitor babies after the surgery. We start them on antibiotics and steroids if they have pale stools or other signs of poor liver function. Through our research, we found that these medications increase the chance that babies will have good bile flow and not immediately need a liver transplant.

Continued care

Our team continues to care for every baby with biliary atresia after evaluation and treatment. During follow-up visits, we often check children's liver function using a special ultrasound machine. If babies regain liver function after the Kasai procedure and are thriving, we may see them only once a year. But visits can be every month for babies who still have impaired liver function or develop complications of biliary atresia. These complications can include:

• Malnourishment
• Recurring liver infections
• High blood pressure in the veins around the liver

Our team includes clinicians with expertise in every aspect of health that may be affected by biliary atresia. For example, we have dietitians that can provide supplements to ensure that children are getting the nutrition they need. It is a joy and honor to follow babies as they become children and teenagers. We help adolescents transition to adult programs that can manage their lifelong care.