{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T22:21:56Z","timestamp":1787869316958,"version":"build-2784847793"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Biliary atresia is a progressive cholangiopathy in neonates, which often results in liver failure. In high\u2010income countries, initial treatment requires prompt diagnosis followed by Kasai portoenterostomy. For those with a late diagnosis, or those in whom Kasai portoenterostomy fails, liver transplantation is the only lifesaving treatment. Unfortunately, in low\u2010 and middle\u2010income countries, timely diagnosis is a challenge and liver transplantation is rarely accessible. Here, we discuss the ethical dilemmas surrounding treatment of babies with biliary atresia in Uganda. Issues that require careful consideration include: risk of catastrophic health expenditure to families, ethical dilemmas of transplant tourism, medical risks of maintaining the transplant in a low\u2010resourced health system, and difficult decisions encountered by the surgeon caring for these patients. Four distinct models of the patient\u2010physician relationship are applied to biliary atresia in Uganda. These models describe differences in patient and physician roles, and patient values and autonomy. Solid organ transplantation is a rapidly evolving segment of healthcare in Uganda and ongoing policy advancements may shift ethical considerations in the future.<\/jats:p>","DOI":"10.1002\/wjs.12166","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T11:48:52Z","timestamp":1711972132000},"page":"2317-2321","source":"Crossref","is-referenced-by-count":3,"title":["Biliary atresia in Uganda: Current ethical challenges and advancement of public policy"],"prefix":"10.1002","volume":"48","author":[{"given":"Nasser","family":"Kakembo","sequence":"first","affiliation":[{"name":"Department of Surgery Makerere University  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Isaac","family":"Loy","sequence":"additional","affiliation":[{"name":"Initiative for Science &amp; Society Duke University  Durham North Carolina USA"},{"name":"College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2208-4017","authenticated-orcid":false,"given":"Tamara N.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University  Durham North Carolina USA"},{"name":"Duke Global Health Institute Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan M.","family":"Antiel","sequence":"additional","affiliation":[{"name":"Department of Surgery Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24640"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1996.01430170039006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(09)60946\u20106"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4314\/ecajs.v21i3.3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2010.11.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2471\/blt.19.236992"},{"key":"e_1_2_9_8_1","unstructured":"Uganda National Household Survey 2019\/2020.2021.Uganda Bureau of Statistics (UBOS)."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0b013e318295ee7d"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010011\u20100385\u20104"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm198908313210919"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.267.16.2221"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000287"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.08.004"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T03:29:53Z","timestamp":1759894193000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":13,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/wjs.12166"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12166","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}