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Because clinicians often do not recognize the presence of underlying liver disease, precise documentation of the disorder can be delayed,which can lead to a subsequent delay in the initiation of effective therapies. Liver transplantation is a reality for pediatric patients who have severe or end-stage liver disease, and other therapies also are now available for treating many liver diseases.

The estimated incidence of neonatal liver disease is as high as 1 in 2,500 live births. Early recognition is particularly important in neonates and infants because a delay in diagnosis may have a negative effect on the prognosis. For example, it is well recognized that when biliary atresia is diagnosed after 2 months of age, the success rate of surgical repair (Kasai hepatoportoenterostomy) declines sharply. Furthermore,because liver dysfunction is progressive, early recognition allows for better nutritional support of the patient and a...

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