Concise Pediatric and Adolescent Hepatology

Abstract

Tabled 1REVIEWER RATINGCoverage of relevant topics★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent.Improvement over previously available media★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent.Style of presentation and formatting★★★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent.Quality of figures★★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent.Overall★★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent.Stars ★: poor; ★★: adequate; ★★★: fair; ★★★★: good; ★★★★★: excellent. Open table in a new tab This is a well-written, easy-to-read textbook, designed to fill a “gap” in the market related to the rapid specialization of pediatric hepatology and the success in ensuring the long-term survival of infants and children who now have the opportunity to transfer to adult care. The book is largely authored by the team from Kings College Hospital, London, and they draw heavily on their extensive experience for the content. The book covers most of the common disorders in pediatric liver disease, but is not a comprehensive textbook. The clinical and diagnostic aspects of neonatal cholestatic liver disease, which is the most common clinical presentation of pediatric liver disease, are not included except as individual conditions in the chapters on progressive familial cholestasis, Alagille syndrome, and biliary atresia. This may have been intentional; the book is intended to focus on adolescent liver diseases. There is little coverage of metabolic liver disease. For instance, there is no mention of galactosemia and tyrosinemia, except under acute liver failure or of glycogen storage disease, or cystic fibrosis liver disease, both of which are diseases of adolescence. There is also no mention of drug-induced liver disease and little discussion about the management of inflammatory bowel disease in association with autoimmune liver disease, which are of concern in older children. The book would have benefited from more editorial control of the content; there is a disparity between chapters on the emphasis on pathophysiology and the molecular basis of the diseases described at the expense of clinical features, presentation, and management strategies. For instance, the chapter on progressive familial cholestasis is mainly based on the histologic aspects of these diseases, with little mention of the clinical and therapeutic issues. The excellent chapter on intestinal failure, parenteral nutrition, and liver disease only briefly mentions intestinal transplantation, an important therapeutic advance for that group of children. In general, the book is light on clinical presentation and management and would have benefited from more photographs, figures, tables, and flow charts, and more definitive guidance on therapy. This would be helpful for trainees seeking therapeutic advice for their patients. In particular, there is no mention of the importance of nutritional supplementation or intensive nutritional support as a management strategy for all forms of liver disease. The highlights of the book include an excellent chapter on growing up with liver disease and a comprehensive chapter on the surgical aspects of liver transplantation, which both address the aim of focusing on adolescent liver disease and the transition to adult care. Bottom Line: This book only partially achieves the aim of highlighting the very challenging aspects of understanding and managing the long-term survival of children with liver disease into adult life. Although well written and interesting to read, the lack of comprehensive inclusion of many significant liver diseases and their management, particularly in adolescence, means that it will be of limited value to trainees, nurses, and allied health professionals, but will interest clinicians with experience of caring for children with liver disease who wish to update their knowledge of pathophysiology, hepatocyte transplantation, and gene therapy.