Newborn Screening for Biliary Atresia.
Newborn Screening for Biliary Atresia.
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DOI：
10.1542/peds.2015-3570
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发表时间：
2015-12
期刊：
影响因子：
8
通讯作者：
Childhood Liver Disease Research Network
中科院分区：
文献类型：
--
作者：
Wang KS;Section on Surgery;Committee on Fetus and Newborn;Childhood Liver Disease Research Network
胆道闭锁是小儿终末期肝病最常见的原因，也是小儿肝移植的主要指征。受影响的婴儿在出生后的最初几周内表现出胆道梗阻的迹象。早期诊断和成功的手术引流胆汁与儿童自体肝脏的更高生存率相关。不幸的是，由于非胆汁淤积性黄疸在婴儿早期非常常见，因此很难鉴别出罕见的胆汁淤积性黄疸婴儿是否患有胆道闭锁。因此，需要及时诊断这种疾病值得讨论的可行性筛选胆道闭锁，以改善结果。在此，美国新生儿胆道闭锁筛查是通过使用新生儿和儿童遗传性疾病自由裁量咨询委员会制定的标准进行评估的。已发表的分析表明，通过使用血清胆红素浓度或粪便颜色卡进行新生儿胆道闭锁筛查可能挽救生命并具有成本效益。在美国，有必要进行进一步的研究来评估早期识别胆道闭锁的潜在筛查策略的可行性、有效性和成本。
Biliary atresia is the most common cause of pediatric end-stage liver disease and the leading indication for pediatric liver transplantation. Affected infants exhibit evidence of biliary obstruction within the first few weeks after birth. Early diagnosis and successful surgical drainage of bile are associated with greater survival with the child’s native liver. Unfortunately, because noncholestatic jaundice is extremely common in early infancy, it is difficult to identify the rare infant with cholestatic jaundice who has biliary atresia. Hence, the need for timely diagnosis of this disease warrants a discussion of the feasibility of screening for biliary atresia to improve outcomes. Herein, newborn screening for biliary atresia in the United States is assessed by using criteria established by the Discretionary Advisory Committee on Heritable Disorders in Newborns and Children. Published analyses indicate that newborn screening for biliary atresia by using serum bilirubin concentrations or stool color cards is potentially life-saving and cost-effective. Further studies are necessary to evaluate the feasibility, effectiveness, and costs of potential screening strategies for early identification of biliary atresia in the United States.