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Vandriel SM, Li L, She H, Wang J, Gilbert MA, Jankowska I, Czubkowski P, Gliwicz‐Miedzińska D, Gonzales EM, Jacquemin E, Bouligand J, Spinner NB, Loomes KM, Piccoli DA, D'Antiga L, Nicastro E, Sokal É, Demaret T, Ebel NH, Feinstein JA, Fawaz R, Nastasio S, Lacaille F, Debray D, Arnell H, Fischler B, Siew S, Stormon M, Karpen SJ, Romero R, Kim KM, Baek WY, Hardikar W, Shankar S, Roberts AJ, Evans HM, Jensen MK, Kavan M, Sundaram SS, Chaidez A, Karthikeyan P, Sanchez MC, Cavalieri ML, Verkade HJ, Lee WS, Squires JE, Hajinicolaou C, Lertudomphonwanit C, Fischer RT, Larson‐Nath C, Mozer‐Glassberg Y, Arikan C, Lin HC, Bernabeu JQ, Alam S, Kelly DA, Carvalho E, Ferreira CT, Indolfi G, Quiros‐Tejeira RE, Bulut P, Calvo PL, Önal Z, Valentino PL, Desai DM, Eshun J, Rogalidou M, Dezsőfi A, Wiecek S, Nebbia G, Pinto RB, Wolters VM, Tamara ML, Zizzo AN, Garcia J, Schwarz K, Beretta M, Sandahl TD, Jimenez‐Rivera C, Kerkar N, Brecelj J, Mujawar Q, Rock N, Busoms CM, Karnsakul W, Lurz E, Santos‐Silva E, Blondet N, Bujanda L, Shah U, Thompson RJ, Hansen BE, Kamath BM. Natural history of liver disease in a large international cohort of children with Alagille syndrome: Results from the GALA study. Hepatology 2023; 77:512-529. [PMID: 36036223 PMCID: PMC9869940 DOI: 10.1002/hep.32761] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS Alagille syndrome (ALGS) is a multisystem disorder, characterized by cholestasis. Existing outcome data are largely derived from tertiary centers, and real-world data are lacking. This study aimed to elucidate the natural history of liver disease in a contemporary, international cohort of children with ALGS. APPROACH AND RESULTS This was a multicenter retrospective study of children with a clinically and/or genetically confirmed ALGS diagnosis, born between January 1997 and August 2019. Native liver survival (NLS) and event-free survival rates were assessed. Cox models were constructed to identify early biochemical predictors of clinically evident portal hypertension (CEPH) and NLS. In total, 1433 children (57% male) from 67 centers in 29 countries were included. The 10 and 18-year NLS rates were 54.4% and 40.3%. By 10 and 18 years, 51.5% and 66.0% of children with ALGS experienced ≥1 adverse liver-related event (CEPH, transplant, or death). Children (>6 and ≤12 months) with median total bilirubin (TB) levels between ≥5.0 and <10.0 mg/dl had a 4.1-fold (95% confidence interval [CI], 1.6-10.8), and those ≥10.0 mg/dl had an 8.0-fold (95% CI, 3.4-18.4) increased risk of developing CEPH compared with those <5.0 mg/dl. Median TB levels between ≥5.0 and <10.0 mg/dl and >10.0 mg/dl were associated with a 4.8 (95% CI, 2.4-9.7) and 15.6 (95% CI, 8.7-28.2) increased risk of transplantation relative to <5.0 mg/dl. Median TB <5.0 mg/dl were associated with higher NLS rates relative to ≥5.0 mg/dl, with 79% reaching adulthood with native liver ( p < 0.001). CONCLUSIONS In this large international cohort of ALGS, only 40.3% of children reach adulthood with their native liver. A TB <5.0 mg/dl between 6 and 12 months of age is associated with better hepatic outcomes. These thresholds provide clinicians with an objective tool to assist with clinical decision-making and in the evaluation of therapies.
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Affiliation(s)
- Shannon M. Vandriel
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children and the University of Toronto, Toronto, Canada
| | - Li‐Ting Li
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Huiyu She
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Jian‐She Wang
- The Center for Pediatric Liver Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Melissa A. Gilbert
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Irena Jankowska
- Department of Gastroenterology, Hepatology, Nutrition Disturbances and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Piotr Czubkowski
- Department of Gastroenterology, Hepatology, Nutrition Disturbances and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Dorota Gliwicz‐Miedzińska
- Department of Gastroenterology, Hepatology, Nutrition Disturbances and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Emmanuel M. Gonzales
- Pediatric Hepatology and Liver Transplantation Unit, National Reference Centre for Rare Pediatric Liver Diseases (Biliary Atresia and Genetic Cholestasis), FILFOIE, ERN RARE LIVER, Bicêtre Hospital, AP‐HP and Inserm U1193, Hepatinov, Université Paris‐Saclay, Le Kremlin‐Bicêtre, France
| | - Emmanuel Jacquemin
- Pediatric Hepatology and Liver Transplantation Unit, National Reference Centre for Rare Pediatric Liver Diseases (Biliary Atresia and Genetic Cholestasis), FILFOIE, ERN RARE LIVER, Bicêtre Hospital, AP‐HP and Inserm U1193, Hepatinov, Université Paris‐Saclay, Le Kremlin‐Bicêtre, France
| | - Jérôme Bouligand
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpitaux Universitaires Paris‐Saclay, Assistance Publique‐Hôpitaux de Paris, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin‐Bicêtre, France
| | - Nancy B. Spinner
- Division of Genomic Diagnostics, Department of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kathleen M. Loomes
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - David A. Piccoli
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lorenzo D'Antiga
- Pediatric Hepatology, Gastroenterology and Transplantation, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Emanuele Nicastro
- Pediatric Hepatology, Gastroenterology and Transplantation, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Étienne Sokal
- Service De Gastroentérologie & Hépatologie Pédiatrique, Cliniques Universitaires Saint‐Luc, Brussels, Belgium
| | - Tanguy Demaret
- Service De Gastroentérologie & Hépatologie Pédiatrique, Cliniques Universitaires Saint‐Luc, Brussels, Belgium
| | - Noelle H. Ebel
- Division of Gastroenterology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jeffrey A. Feinstein
- Department of Pediatrics (Cardiology), Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, California, USA
| | - Rima Fawaz
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Silvia Nastasio
- Division of Gastroenterology, Hepatology, & Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Florence Lacaille
- Department of Pediatric Gastroenterology, and Nutrition, Necker‐Enfants Malades Hospital, University of Paris, Paris, France
| | - Dominique Debray
- Pediatric Liver Unit, National Reference Centre for Rare Pediatric Liver Diseases (Biliary Atresia and Genetic Cholestasis), FILFOIE, ERN RARE LIVER, Necker‐Enfants Malades Hospital, University of Paris, Paris, France
| | - Henrik Arnell
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Björn Fischler
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Susan Siew
- Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, Australia
| | - Michael Stormon
- Department of Gastroenterology, The Children's Hospital at Westmead, Sydney, Australia
| | - Saul J. Karpen
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rene Romero
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, Children's Healthcare of Atlanta & Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kyung Mo Kim
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Republic of Korea
| | - Woo Yim Baek
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children's Hospital, Seoul, Republic of Korea
| | - Winita Hardikar
- Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Australia
| | - Sahana Shankar
- Mazumdar Shaw Medical Center, Narayana Health, Bangalore, India
| | - Amin J. Roberts
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - Helen M. Evans
- Department of Paediatric Gastroenterology, Starship Child Health, Auckland, New Zealand
| | - M. Kyle Jensen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Utah, Salt Lake City, Utah, USA
| | - Marianne Kavan
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Utah, Salt Lake City, Utah, USA
| | - Shikha S. Sundaram
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children's Hospital of Colorado and University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Alexander Chaidez
- Section of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics and the Digestive Health Institute, Children's Hospital of Colorado and University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | - Maria Camila Sanchez
- Pediatric Gastroenterology and Hepatology Division, Hospital Italiano Buenos Aires, Buenos Aires, Argentina
| | - Maria Lorena Cavalieri
- Pediatric Gastroenterology and Hepatology Division, Hospital Italiano Buenos Aires, Buenos Aires, Argentina
| | - Henkjan J. Verkade
- Department of Pediatrics, Center for Liver, Digestive, and Metabolic Diseases, University Medical Center Groningen, Groningen, The Netherlands
| | - Way Seah Lee
- Faculty of Medicine, Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
| | - James E. Squires
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Christina Hajinicolaou
- Division of Paediatric Gastroenterology, Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | - Chatmanee Lertudomphonwanit
- Division of Gastroenterology, Department of Pediatrics, Ramathibodi Hospital Mahidol University, Bangkok, Thailand
| | - Ryan T. Fischer
- Department of Gastroenterology, Section of Hepatology, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Catherine Larson‐Nath
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Yael Mozer‐Glassberg
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Cigdem Arikan
- Department of Pediatric Gastroenterology and Organ Transplant, Koc University School of Medicine, Istanbul, Turkey
| | - Henry C. Lin
- Division of Pediatric Gastroenterology, Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Jesus Quintero Bernabeu
- Pediatric Hepatology and Liver Transplant Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Seema Alam
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Deirdre A. Kelly
- Liver Unit, Birmingham Women's & Children's Hospital NHS Trust, University of Birmingham, Birmingham, UK
| | - Elisa Carvalho
- Pediatric Gastroenterology Department, Hospital da Criança de Brasília, Centro Universitário de Brasília, Brasília, Brazil
| | - Cristina Targa Ferreira
- Pediatric Gastroenterology Service, Hospital da Criança Santo Antôni, Universidade Federal de Ciências da Saúde de Porto Alegre, Complexo Hospitalar Santa Casa, Porto Alegre, RS, Brazil
| | - Giuseppe Indolfi
- Paediatric and Liver Unit, Department Neurofarba, University of Florence and Meyer Children's University Hospital, Florence, Italy
| | - Ruben E. Quiros‐Tejeira
- Department of Pediatrics, Children's Hospital & Medical Center and University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Pinar Bulut
- Division of Pediatric Gastroenterology and Hepatology, Phoenix Children's Hospital, Phoenix, USA
| | - Pier Luigi Calvo
- Pediatric Gastroenterology Unit, Regina Margherita Children's Hospital, Azienda Ospedaliera‐Universitaria Citta' della Salute e della Scienza, Turin, Italy
| | - Zerrin Önal
- Pediatric Gastroenterology, Hepatology and Nutrition Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Pamela L. Valentino
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Dev M. Desai
- Solid Organ Transplant Department, Children's Health – Children's Medical Center, Dallas, Texas, USA
| | - John Eshun
- Department of Pediatric Gastroenterology, Le Bonheur Children's Hospital, The University of Tennessee Health Science Center, Memphis, Texas, USA
| | - Maria Rogalidou
- Division of Gastroenterology & Hepatology, First Department of Pediatrics, “Agia Sofia” Children's Hospital, University of Athens, Athens, Greece
| | - Antal Dezsőfi
- First Department of Paediatrics, Semmelweis University, Budapest, Hungary
| | - Sabina Wiecek
- Department of Pediatrics, Medical University of Silesia in Katowice, Katowice, Poland
| | - Gabriella Nebbia
- Servizio di Epatologia Pediatrica, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raquel Borges Pinto
- Division of Pediatric Gastroenterology of Hospital da Criança Conceição do Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil
| | - Victorien M. Wolters
- Department of Pediatric Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Andréanne N. Zizzo
- Division of Paediatric Gastroenterology and Hepatology, London Health Sciences Centre, Children's Hospital, Western University, London, Ontario, Canada
| | - Jennifer Garcia
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Miami Transplant Institute, University of Miami, Miami, Florida, USA
| | - Kathleen Schwarz
- Division of Pediatric Gastroenterology, University of California San Diego, Rady Children's Hospital San Diego, San Diego, California, USA
| | - Marisa Beretta
- Faculty of Health Sciences, Wits Donald Gordon Medical Centre, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Carolina Jimenez‐Rivera
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Nanda Kerkar
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
| | - Jernej Brecelj
- Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Faculty of Medicine, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Quais Mujawar
- Section of Pediatric Gastroenterology, Department of Pediatrics, University of Manitoba, Winnipeg, Canada
| | - Nathalie Rock
- Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Cristina Molera Busoms
- Pediatric Gastroenterology Hepatology and Nutrition Unit, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Wikrom Karnsakul
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eberhard Lurz
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Ermelinda Santos‐Silva
- Pediatric Gastroenterology Unit, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| | - Niviann Blondet
- Gastroenterology and Hepatology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Luis Bujanda
- Department of Hepatology and Gastroenterology, Biodonostia Health Research Institute, Donostia University Hospital, Universidad del País Vasco (UPV/EHU), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), San Sebastián, Spain
| | - Uzma Shah
- Harvard Medical School, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
| | | | - Bettina E. Hansen
- Toronto General Hospital University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada
| | - Binita M. Kamath
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children and the University of Toronto, Toronto, Canada
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2
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van Wessel DB, Thompson RJ, Gonzales E, Jankowska I, Shneider BL, Sokal E, Grammatikopoulos T, Kadaristiana A, Jacquemin E, Spraul A, Lipiński P, Czubkowski P, Rock N, Shagrani M, Broering D, Algoufi T, Mazhar N, Nicastro E, Kelly D, Nebbia G, Arnell H, Fischler B, Hulscher JB, Serranti D, Arikan C, Debray D, Lacaille F, Goncalves C, Hierro L, Muñoz Bartolo G, Mozer‐Glassberg Y, Azaz A, Brecelj J, Dezsőfi A, Luigi Calvo P, Krebs‐Schmitt D, Hartleif S, van der Woerd WL, Wang J, Li L, Durmaz Ö, Kerkar N, Hørby Jørgensen M, Fischer R, Jimenez‐Rivera C, Alam S, Cananzi M, Laverdure N, Targa Ferreira C, Ordonez F, Wang H, Sency V, Mo Kim K, Chen H, Carvalho E, Fabre A, Quintero Bernabeu J, Alonso EM, Sokol RJ, Suchy FJ, Loomes KM, McKiernan PJ, Rosenthal P, Turmelle Y, Rao GS, Horslen S, Kamath BM, Rogalidou M, Karnsakul WW, Hansen B, Verkade HJ. Impact of Genotype, Serum Bile Acids, and Surgical Biliary Diversion on Native Liver Survival in FIC1 Deficiency. Hepatology 2021; 74:892-906. [PMID: 33666275 PMCID: PMC8456904 DOI: 10.1002/hep.31787] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Mutations in ATPase phospholipid transporting 8B1 (ATP8B1) can lead to familial intrahepatic cholestasis type 1 (FIC1) deficiency, or progressive familial intrahepatic cholestasis type 1. The rarity of FIC1 deficiency has largely prevented a detailed analysis of its natural history, effects of predicted protein truncating mutations (PPTMs), and possible associations of serum bile acid (sBA) concentrations and surgical biliary diversion (SBD) with long-term outcome. We aimed to provide insights by using the largest genetically defined cohort of patients with FIC1 deficiency to date. APPROACH AND RESULTS This multicenter, combined retrospective and prospective study included 130 patients with compound heterozygous or homozygous predicted pathogenic ATP8B1 variants. Patients were categorized according to the number of PPTMs (i.e., splice site, frameshift due to deletion or insertion, nonsense, duplication), FIC1-A (n = 67; no PPTMs), FIC1-B (n = 29; one PPTM), or FIC1-C (n = 34; two PPTMs). Survival analysis showed an overall native liver survival (NLS) of 44% at age 18 years. NLS was comparable among FIC1-A, FIC1-B, and FIC1-C (% NLS at age 10 years: 67%, 41%, and 59%, respectively; P = 0.12), despite FIC1-C undergoing SBD less often (% SBD at age 10 years: 65%, 57%, and 45%, respectively; P = 0.03). sBAs at presentation were negatively associated with NLS (NLS at age 10 years, sBAs < 194 µmol/L: 49% vs. sBAs ≥ 194 µmol/L: 15%; P = 0.03). SBD decreased sBAs (230 [125-282] to 74 [11-177] μmol/L; P = 0.005). SBD (HR 0.55, 95% CI 0.28-1.03, P = 0.06) and post-SBD sBA concentrations < 65 μmol/L (P = 0.05) tended to be associated with improved NLS. CONCLUSIONS Less than half of patients with FIC1 deficiency reach adulthood with native liver. The number of PPTMs did not associate with the natural history or prognosis of FIC1 deficiency. sBA concentrations at initial presentation and after SBD provide limited prognostic information on long-term NLS.
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Affiliation(s)
- Daan B.E. van Wessel
- Pediatric Gastroenterology and HepatologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | | | - Emmanuel Gonzales
- Pediatric Hepatology & Pediatric Liver Transplant DepartmentCentre de Référence de l’Atrésie des Voies Biliaires et des Cholestases GénétiquesFilière de Santé des Maladies Rares du Foie de l’enfant et de l’adulteEuropean Reference Network RARE‐LIVERAssistance Publique‐Hôpitaux de ParisFaculté de Médecine Paris‐SaclayCHU BicêtreParisFrance
- European Reference Network on Hepatological Diseases
| | - Irena Jankowska
- European Reference Network on Hepatological Diseases
- Gastroenterology, Hepatology, Nutritional Disorders and Pediatricsthe Children’s Memorial Health InstituteWarsawPoland
| | - Benjamin L. Shneider
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsBaylor College of MedicineHoustonTXUSA
- Childhood Liver Disease Research Network (ChiLDReN)
| | - Etienne Sokal
- European Reference Network on Hepatological Diseases
- Cliniques St. LucUniversité Catholique de LouvainBrusselsBelgium
| | | | | | - Emmanuel Jacquemin
- Pediatric Hepatology & Pediatric Liver Transplant DepartmentCentre de Référence de l’Atrésie des Voies Biliaires et des Cholestases GénétiquesFilière de Santé des Maladies Rares du Foie de l’enfant et de l’adulteEuropean Reference Network RARE‐LIVERAssistance Publique‐Hôpitaux de ParisFaculté de Médecine Paris‐SaclayCHU BicêtreParisFrance
- INSERMUMR‐S 1193Université Paris‐SaclayOrsayFrance
| | - Anne Spraul
- INSERMUMR‐S 1193Université Paris‐SaclayOrsayFrance
- Biochemistry UnitCentre de Référence de l’Atrésie des Voies Biliaires et des Cholestases GénétiquesFilière de Santé des Maladies Rares du Foie de l’enfant et de l’adulteEuropean Reference Network RARE‐LIVERAssistance Publique‐Hôpitaux de ParisFaculté de Médecine Paris‐SaclayCHU BicêtreParisFrance
| | - Patryk Lipiński
- European Reference Network on Hepatological Diseases
- Gastroenterology, Hepatology, Nutritional Disorders and Pediatricsthe Children’s Memorial Health InstituteWarsawPoland
| | - Piotr Czubkowski
- European Reference Network on Hepatological Diseases
- Gastroenterology, Hepatology, Nutritional Disorders and Pediatricsthe Children’s Memorial Health InstituteWarsawPoland
| | - Nathalie Rock
- Cliniques St. LucUniversité Catholique de LouvainBrusselsBelgium
| | - Mohammad Shagrani
- Department of Liver & SB Transplant & Hepatobiliary‐Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia
- College of MedicineAlfaisal UniversityRiyadhSaudi Arabia
| | - Dieter Broering
- Department of Liver & SB Transplant & Hepatobiliary‐Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia
| | - Talal Algoufi
- Department of Liver & SB Transplant & Hepatobiliary‐Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia
| | - Nejat Mazhar
- Department of Liver & SB Transplant & Hepatobiliary‐Pancreatic SurgeryKing Faisal Specialist Hospital & Research CenterRiyadhSaudi Arabia
| | - Emanuele Nicastro
- Pediatric Hepatology, Gastroenterology and TransplantationOspedale Papa Giovanni XXIIIBergamoItaly
| | - Deirdre Kelly
- European Reference Network on Hepatological Diseases
- Liver UnitBirmingham Women’s and Children’s HospitalUniversity of BirminghamBirminghamUnited Kingdom
| | - Gabriella Nebbia
- Servizio Di Epatologia e Nutrizione PediatricaFondazione Irccs Ca’ Granda Ospedale Maggiore PoliclinicoMilanoItaly
| | - Henrik Arnell
- European Reference Network on Hepatological Diseases
- Pediatric Digestive DiseasesAstrid Lindgren Children’s HospitalCLINTECKarolinska InstitutetKarolinska University HospitalStockholmSweden
| | - Björn Fischler
- European Reference Network on Hepatological Diseases
- Pediatric Digestive DiseasesAstrid Lindgren Children’s HospitalCLINTECKarolinska InstitutetKarolinska University HospitalStockholmSweden
| | - Jan B.F. Hulscher
- European Reference Network on Hepatological Diseases
- Pediatric SurgeryUniversity Medical Center GroningenGroningenthe Netherlands
| | - Daniele Serranti
- Pediatric and Liver UnitMeyer Children’s University Hospital of FlorenceFlorenceItaly
| | - Cigdem Arikan
- Pediatric GI and Hepatology Liver Transplantation CenterKuttam System in Liver MedicineKoc University School of MedicineIstanbulTurkey
| | - Dominique Debray
- Pediatric Hepatology unit, Reference Center for Biliary Atresia and Genetic Cholestatic DiseasesFilière de Santé des Maladies Rares du Foie de l’enfant et de l’adulteEuropean Reference Network RARE‐LIVERAPHP‐Neckler Enfants Malades University HospitalFaculté de Médecine Paris‐CentreParisFrance
| | - Florence Lacaille
- Pediatric Hepatology unit, Reference Center for Biliary Atresia and Genetic Cholestatic DiseasesFilière de Santé des Maladies Rares du Foie de l’enfant et de l’adulteEuropean Reference Network RARE‐LIVERAPHP‐Neckler Enfants Malades University HospitalFaculté de Médecine Paris‐CentreParisFrance
| | - Cristina Goncalves
- European Reference Network on Hepatological Diseases
- Coimbra University Hospital CenterCoimbraPortugal
| | - Loreto Hierro
- European Reference Network on Hepatological Diseases
- Pediatric Liver ServiceLa Paz University HospitalMadridSpain
| | - Gema Muñoz Bartolo
- European Reference Network on Hepatological Diseases
- Pediatric Liver ServiceLa Paz University HospitalMadridSpain
| | - Yael Mozer‐Glassberg
- Institute of Gastroenterology, Nutrition and Liver DiseasesSchneider Children’s Medical Center of IsraelPetach TikvahIsrael
| | - Amer Azaz
- Sheikh Khalifa Medical CityAbu DhabiUnited Arab Emirates
| | - Jernej Brecelj
- Department of Gastroenterology, Hepatology and NutritionUniversity Children’s Hospital LjubljanaLjubljanaSlovenia
- Department of PediatricsFaculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Antal Dezsőfi
- First Department of PediatricsSemmelweis UniversityBudapestHungary
| | - Pier Luigi Calvo
- Pediatic Gastroenterology UnitRegina Margherita Children’s HospitalAzienda Ospedaliera Città Della Salute e Della Scienza University HospitalTorinoItaly
| | | | - Steffen Hartleif
- European Reference Network on Hepatological Diseases
- University Children’s Hospital TϋbingenTϋbingenGermany
| | - Wendy L. van der Woerd
- Pediatric Gastroenterology, Hepatology and NutritionWilhelmina Children’s HospitalUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Jian‐She Wang
- Children’s Hospital of Fudan UniversityShanghaiChina
| | - Li‐ting Li
- Children’s Hospital of Fudan UniversityShanghaiChina
| | - Özlem Durmaz
- Istanbul Faculty of MedicineIstanbul UniversityIstanbulTurkey
| | - Nanda Kerkar
- Pediatric Gastroenterology, Hepatology and NutritionUniversity of Rochester Medical CenterRochesterNYUSA
| | - Marianne Hørby Jørgensen
- European Reference Network on Hepatological Diseases
- Pediatric and Adolescent DepartmentDepartment of Pediatrics and Adolescent MedicineRigshospitalet Copenhagen University HospitalCopenhagenDenmark
| | - Ryan Fischer
- Section of Hepatology and Transplant MedicineChildren’s Mercy HospitalKansas CityMOUSA
| | - Carolina Jimenez‐Rivera
- Department of PediatricsChildren’s Hospital of Eastern OntarioUniversity of OttawaOttawaCanada
| | - Seema Alam
- Pediatric HepatologyInstitute of Liver and Biliary SciencesNew DelhiIndia
| | - Mara Cananzi
- European Reference Network on Hepatological Diseases
- Pediatric Gastroenterology and HepatologyUniversity Hospital of PadovaPadovaItaly
| | - Noémie Laverdure
- European Reference Network on Hepatological Diseases
- Service de Gastroentérologie, Hépatologie et Nutrition PédiatriquesHospices Civils de LyonHôpital Femme Mère EnfantLyonFrance
| | | | - Felipe Ordonez
- Fundación Cardioinfantil Instituto de CardiologiaPediatric Gastroenterology and HepatologyBogotáColombia
| | - Heng Wang
- DDC Clinic Center for Special Needs ChildrenMiddlefieldOHUSA
| | - Valerie Sency
- DDC Clinic Center for Special Needs ChildrenMiddlefieldOHUSA
| | - Kyung Mo Kim
- Department of PediatricsAsan Medical Center Children’s HospitalSeoulSouth Korea
| | - Huey‐Ling Chen
- Division of Pediatric Gastroenterology, Hepatology and NutritionNational Taiwan University Children’s HospitalTaipeiTaiwan
| | - Elisa Carvalho
- Pediatric Gastroenterology and HepatologyBrasília Children’s HospitalBrasiliaBrazil
| | - Alexandre Fabre
- INSERMMMGAix Marseille UniversityMarseilleFrance
- Serveice de Pédiatrie MultidisciplinaireTimone EnfantMarseilleFrance
| | - Jesus Quintero Bernabeu
- European Reference Network on Hepatological Diseases
- Pediatric Hepatology and Liver Transplant UnitBarcelonaSpain
| | - Estella M. Alonso
- Childhood Liver Disease Research Network (ChiLDReN)
- Division of Pediatric Gastroenterology, Hepatology and NutritionAnn & Robert H. Lurie Children’s HospitalChicagoILUSA
| | - Ronald J. Sokol
- Childhood Liver Disease Research Network (ChiLDReN)
- Section of Pediatric Gastroenterology, Hepatology and NutritionDepartment of PediatricsChildren’s Hospital ColoradoUniversity of Colorado School of MedicineAuroraCOUSA
| | - Frederick J. Suchy
- Childhood Liver Disease Research Network (ChiLDReN)
- Icahn School of Medicine at Mount SinaiMount Sinai Kravis Children’s HospitalNew YorkNYUSA
| | - Kathleen M. Loomes
- Childhood Liver Disease Research Network (ChiLDReN)
- Division of Gastroenterology, Hepatology and NutritionChildren’s Hospital of PhiladelphiaPhiladelphiaPAUSA
| | - Patrick J. McKiernan
- Childhood Liver Disease Research Network (ChiLDReN)
- Department of Pediatric Gastroenterology and HepatologyUniversity of Pittsburgh Medical Center Children’s Hospital of PittsburghPittsburghPAUSA
| | - Philip Rosenthal
- Childhood Liver Disease Research Network (ChiLDReN)
- Department of Pediatrics and SurgeryUCSF Benioff Children’s HospitalUniversity of California San Francisco School of MedicineSan FranciscoCAUSA
| | - Yumirle Turmelle
- Childhood Liver Disease Research Network (ChiLDReN)
- Section of HepatologyDepartment of PediatricsSt. Louis Children’s HospitalWashington University School of MedicineSt. LouisMOUSA
| | - Girish S. Rao
- Childhood Liver Disease Research Network (ChiLDReN)
- Riley Hospital for ChildrenIndiana University School of MedicineIndianapolisINUSA
| | - Simon Horslen
- Childhood Liver Disease Research Network (ChiLDReN)
- Department of PediatricsSeattle Children’s HospitalUniversity of WashingtonSeattleWAUSA
| | - Binita M. Kamath
- Childhood Liver Disease Research Network (ChiLDReN)
- The Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
| | - Maria Rogalidou
- Division of Pediatric Gastroenterology & HepatologyFirst Pediatrics DepartmentUniversity of AthensAgia Sofia Children’s HospitalAthensGreece
| | - Wikrom W. Karnsakul
- Division of Pediatric Gastroenterology, Nutrition, and HepatologyDepartment of PediatricsJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Bettina Hansen
- Toronto Center for Liver DiseaseUniversity Health NetworkTorontoCanada
- IHPMEUniversity of TorontoTorontoCanada
| | - Henkjan J. Verkade
- Pediatric Gastroenterology and HepatologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
- European Reference Network on Hepatological Diseases
| | | |
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