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PFIC- Outcome and Time to Transplant After Biliary Diversion According to Genetic Subtypes

M. Schulze1, A. Sahloul2, E. Lainka3

1Organ Transplant Centre of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, 2Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany, 3Department of Pediatric Gastroenterology, University Hospital Essen, Essen, Germany

Meeting: 2022 American Transplant Congress

Abstract number: 1449

Keywords: Pediatric, Quality of life

Topic: Clinical Science » Liver » 61 - Liver: Pediatrics

Session Information

Session Name: Liver: Pediatrics

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Progressive familial intrahepatic Cholestasis (PFIC) is a heterogeneous autosomal recessive disease characterized by progressive cholestasis, pruritus leading to liver injury. Surgical therapy aims in preventing bile absorption either by external or internal biliary diversion. Three different genetic subtypes encode for defects in bile transport proteins. Since PFIC type 3 progresses to cirrhosis, this study describes the outcome of biliary diversion in the PFIC II and I patients.

*Methods: Clinical data and laboratory findings of all PFIC Patient (n=33), who were treated and managed in our hospital between 2000 and 2020, were analyzed retrospectively.

*Results: We treated 33 patients, PFIC I (n=9), II (n=17) and III (n=7). Biliary diversion was performed in 12 patients PFIC I (n = 6) and II (n =6)]. Bile acids (BA), bilirubin and liver enzymes were elevated in all patients. After biliary diversion BA, bilirubin and triglyceride levels significantly decreased only in PFIC I patients. Four PFIC I Patients did not require liver transplantation. Liver transplantation was necessary in two children because of stoma complications liver failure. Five out of six PFIC II patients, who had biliary diversion, needed a liver transplantation. One child with normal liver values underwent biliary diversion due to itching, which improved transiently after the operation and then reoccurred in the short term.

*Conclusions: Only PFIC I patients showed a significant decrease in bile acids, bilirubin levels as well as triglycerides and benefited from biliary diversion. The type of membrane transporter defect underlying the different PFIC subtypes could further explain this.

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To cite this abstract in AMA style:

Schulze M, Sahloul A, Lainka E. PFIC- Outcome and Time to Transplant After Biliary Diversion According to Genetic Subtypes [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/pfic-outcome-and-time-to-transplant-after-biliary-diversion-according-to-genetic-subtypes/. Accessed May 28, 2025.

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