Young people with biliary atresia requiring liver transplantation: a distinct population requiring specialist care

Background Young people born with biliary atresia are an emerging population for adult hepatologists with 40-45% of children entering adolescence with their native liver intact. For those requiring liver transplantation during adolescence, disparity on the waiting list and post liver transplantation outcome for young adults compared to younger and older age groups has stimulated discussion regarding the optimal timing of listing. In this study we review our experience of young people with biliary atresia requiring liver transplantation during adolescence and young adulthood. Methods Retrospective, single centre review of patients with biliary atresia requiring liver transplantation > 11 years. Results Thirty-six young people (16 male) underwent liver transplantation between 1991-2014 at a median age of 16.6 (IQR 14.2,19.5) years. The commonest indications for listing were refractory cholangitis (31%), synthetic failure (25%) and variceal bleeding (14%). Patients listed by the adult team (n=14) waited longer than those listed by the paediatric team (10 (IQR 7.7,24.6) vs 5.8 (IQR 4.0,15.1) months (p

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