Corticosteroides para os pacientes com atresia biliar submetidos a hepatoportoenterostomia de kasai

Abstract

Introduction: Biliary atresia (BA) is the major cause of end-stage liver cirrhosis in childhood and the most common indication for pediatric liver transplantation in the world. Even though only a palliative surgery and with variable results, Kasai hepatoportoenterostomy (HPE) continues to be the cornerstone treatment. Due to its assumed anti-inflammatory, immunomodulatory and choleretic properties corticosteroids could improve biliary drainage and native liver survival. The objective of this study is to carry out an integrative review of the efficacy of post-operative corticoid adjuvant therapy in BA patients after HPE. Methods: Bibliographic survey of English written papers published in the last 20 years was performed in all medical databases available on Portal Capes. Results: Fifteen papers, two of them RCTs, were retrieved. Most failed to demonstrate benefits associated with corticoid use and some authors observed adverse effects that should be considered before prescribing them. Conclusion: So far, there is no evidence for the use of corticosteroids in the postoperative period of Kasai's HPE, since there is no proven benefit in terms of improved survival with native liver or biliary drainage. In addition, serious adverse effects and growth interference are reported