Infant Jaundice: Updates in Biliary Atresia.

Alyssa Stetson, Marissa Ray, Michael Rogers, Gregory M Tiao

Journal: Advances in pediatrics 2026;73(1):239-251

PMID: 42481093

Abstract

Biliary atresia is a leading cause of neonatal cholestasis and the most common indication for pediatric liver transplantation. Early recognition is critical, as outcomes depend on timely surgical intervention with the Kasai portoenterostomy. Advances in the diagnostic work-up of infant jaundice now emphasize earlier differentiation of cholestatic from physiologic causes using fractionated bilirubin screening, direct bilirubin measurement in newborn panels, and noninvasive imaging techniques such as ultrasound. Emerging biomarkers and genetic testing show promise in supporting earlier detection, reducing delays in referral, and improving long-term outcomes for infants with biliary atresia.

Address: Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH 45267-0558, USA. Electronic address: [email protected].; Division of Gastroenterology, Hepatology, and Nutrition, UC Department of Pediatrics, 420 Albert Sabin Way, ML 2010, Cincinnati, OH 45229, USA.; Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Surgery, Division of Gastroenterology, Hepatology, and Nutrition, Pediatric General and Thoracic Surgery, Liver Transplant Program, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

DOI: 10.1016/j.yapd.2025.12.009

MeSH Terms: Humans, Biliary Atresia, Jaundice, Neonatal, Infant, Newborn, Portoenterostomy, Hepatic, Liver Transplantation, Infant, Bilirubin