The most prevalent cause for a liver transplant in children is biliary atresia (BA) and results at hepatoportoenterostomy decrease with age (HPE). In a population-based cohort of children in Ontario, Canada, researchers compared direct health care expenditures in children with BA to controls. They identified all children diagnosed with BA between 2002 and 2016, as well as matched controls, using health administrative data. They calculated yearly direct healthcare expenditures as well as rates of usage of health services, liver transplantation, mortality, portal hypertension, cirrhosis, esophageal varices, and severe upper gastrointestinal hemorrhage necessitating hospitalization. The relationship between age at HPE, risk of a liver transplant, and direct expenses were evaluated using multivariable regression models. BA occurred at a rate of 6.07 per 100,000 live births. When compared to controls, BA patients had higher yearly median direct health care expenses. There was no significant relationship between direct expenses and HPE 90 days or 45 to 90 days when compared to age at HPE 45 days. When compared to age 45 days, age at HPE 90 days was substantially related to the chance of receiving a liver transplant. Patients with BA who received liver transplantation had greater direct expenses than those who did not.

Direct health-care expenditures were significant in BA patients, particularly those who received liver transplantation. The risk of liver transplantation was linked with age at HPE, but not with direct health care expenditures, usage, or other risk outcomes.