Steroids in the Treatment of Biliary Atresia

Biliary atresia is a condition in which the common hepatic bile duct becomes blocked, preventing bile drainage from the liver. Biliary atresia occurs in infants and requires portoenterostomy, a surgical procedure, in order to re-establish bile flow from the liver to the small intestine. Despite the surgical intervention, about half of the children will need a liver transplant before the age of five. The aim of the START study was to determine whether corticosteroid treatment after portoenterostomy would improve bile drainage and reduce the need for liver transplantation, compared to surgery alone. The START study participants were recruited from the ChiLDREN prospective observational database study and randomized into either the corticosteroid or placebo group within 72 hours after the portoenterostomy procedure. Patients were given their assigned treatments daily over the course of 13 weeks. After the treatment period, patients underwent follow-up testing and assessments until age 24 months. The data package now includes analysis datasets (Bezerra) from a publication.