Centralization of Biliary Atresia: Has Germany Learned Its Lessons?

This German national study compared biliary atresia outcomes between 2010-2014 and 2001-2005, finding modest but non-significant improvements in survival and native liver preservation after Kasai portoenterostomy. Despite recommendations for centralization, BA treatment remains dispersed across 21 centers, suggesting voluntary referral policies have not achieved optimal concentration of care at specialized liver units.