Language

English

Publication Date

4-1-2025

Journal

Journal of Pediatric Gastroenterology and Nutrition

DOI

10.1002/jpn3.12462

PMID

39840645

PMCID

PMC11961318

PubMedCentral® Posted Date

4-1-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Pediatric cholestatic liver diseases are rare conditions that can result from multiple specific underlying etiologies. Among the most common etiologies of pediatric cholestatic liver diseases are biliary atresia, Alagille syndrome (ALGS), and inherited disorders of bile acid transport. These diseases are characterized by episodic or chronic unremitting cholestasis. Due to the chronicity of these conditions, it is imperative to optimize medical management to improve patient quality of life, provide nutritional support, and reduce bile acid toxicity in efforts to slow disease progression. Cholestatic liver diseases remain the leading cause of pediatric liver transplantation, as many underlying disease etiologies have no curative medical therapies. In the present review, we provide an update on the nutritional, medical, and surgical management of pediatric cholestatic liver diseases. As recent advances have occurred in the field with the addition of ileal bile acid transporter (IBAT) inhibitors, we also review the results from prospective clinical trials, including their strengths and limitations. While recent clinical trials have demonstrated improved pruritus using IBAT inhibitors in ALGS and progressive familial intrahepatic cholestasis, establishing medical therapies proven to slow disease progression remains an area of unmet need.

Keywords

Humans, Child, Alagille Syndrome, Cholestasis, Biliary Atresia, Cholestasis, Intrahepatic, Liver Transplantation, Bile Acids and Salts

Published Open-Access

yes

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