Newborn Screening for Biliary Atresia胆道闭锁新生儿筛查

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1、TECHNICALREPORTNewbornScreeningforBiliaryAtresiaKasperS.Wang,MD,FAAP,FACS,THESECTIONONSURGERY,THECOMMITTEEONFETUSANDNEWBORN,THECHILDHOODLIVERDISEASERESEARCHNETWORKBiliaryatresiaisthemostcommoncauseofpediatricend-stageliverdiseaseabstractandtheleadingindicationforpediatriclivertranspla

2、ntation.Affectedinfantsexhibitevidenceofbiliaryobstructionwithinthefirstfewweeksafterbirth.Earlydiagnosisandsuccessfulsurgicaldrainageofbileareassociatedwithgreatersurvivalwiththechild’snativeliver.Unfortunately,becausenoncholestaticjaundiceisextremelycommoninearlyinfancy,itisdifficultt

3、oidentifytherareinfantwithcholestaticjaundicewhohasbiliaryatresia.Hence,theneedfortimelydiagnosisofthisdiseasewarrantsadiscussionofthefeasibilityofscreeningforbiliaryatresiatoimproveoutcomes.Herein,newbornscreeningforbiliaryatresiaintheUnitedStatesisassessedbyusingcriteriaestablishedb

4、ytheDiscretionaryAdvisoryCommitteeonHeritableDisordersinNewbornsandChildren.Publishedanalysesindicatethatnewbornscreeningforbiliaryatresiabyusingserumbilirubinconcentrationsorstoolcolorcardsispotentiallylife-savingandcost-effective.Furtherstudiesarenecessarytoevaluatethefeasibility,ef

5、fectiveness,andcostsofpotentialscreeningstrategiesforearlyidentificationofbiliaryatresiaintheUnitedStates.ThisdocumentiscopyrightedandispropertyoftheAmericanAcademyofPediatricsanditsBoardofDirectors.AllauthorshavefiledBiliaryatresiaisthemostcommoncauseofpediatricend-stageliverconflictofi

6、ntereststatementswiththeAmericanAcademyofdiseaseandtheleadingindicationforpediatriclivertransplantation.1Pediatrics.AnyconflictshavebeenresolvedthroughaprocessapprovedbytheBoardofDirectors.TheAmericanAcademyofInfantswithbiliaryatresiadevelopjaundiceandpale,acholicstoolsPediatricshasnei

7、thersolicitednoracceptedanycommercialwithinthefirstfewweeksafterbirth,secondarytofibroinflammatoryinvolvementinthedevelopmentofthecontentofthispublication.obstructionoftheextrahepaticbileductsthatdrainbilefromtheTechnicalreportsfromtheAmericanAcademyofPediatricsbenefitliverintotheintestin

8、es.Ea