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Background. Biliary atresia can be treated by portoenterostomy, which is primarily palliative, or by liver transplantation, which is primarily curative. The purpose of this study was to determine the long-term outcome of liver transplantation for the treatment of biliary atresia.
Methods. During an 8-year period, 45 patients who underwent liver transplantation for biliary atresia and 10 patients who were referred to our center for portoenterostomy were retrospectively analyzed.
Results. No patient with biliary atresia died awaiting liver transplantation. The waiting time for all patients was 36.7 ± 42.8 days. Thirty-four patients (75.6%) required one transplant, whereas 11 patients (24.4%) required 17 retransplants. Twenty-two patients (48.9%) required 39 reoperations (1.8 per patient). There were 4.9 infectious episodes, 2.2 rejection episodes, and 4.4 readmissions per patient. However, 91% of reoperations, 80% of infections, and 78% of rejections occurred within 6 months of transplantation. The overall 7-year actuarial patient and graft survival for patients with biliary atresia was 86.2% and 62.7%, respectively.
Conclusions. Our results indicate that long-term patient survival after liver transplantation for biliary atresia is excellent. However, portoenterostomy continues to have an initial complementary but limited long-term role in the treatment of infants with biliary atresia.
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- Surgical treatment of biliary atresia.J Pediatr Surg. 1968; 3: 665-675
- Prognosis of uncorrected biliary atresia: an update.J Pediatr Surg. 1978; 13: 389-391
- The Surgery of biliary atresia.Ann Surg. 1989; 210: 289-296
- The efficacy of hepatoportoenterostomy in biliary atresia.Surgery. 1989; 106: 692-701
- A long-term experience with biliary atresia: reassessment of prognostic factors.Ann Surg. 1991; 214: 590-598
- Biliary atresia registry, 1976 to 1989.J Pediatr Surg. 1990; 25: 1076-1081
- Reduced-size orthotopic liver graft in hepatic transplantation in children.Surgery. 1984; 95: 367-370
- The concept and technique of the split liver in clinical transplantation.Surgery. 1990; 107: 605-612
- Liver transplantation in children from living related donors: surgical techniques and results.Ann Surg. 1991; 214: 428-439
- Liver transplantation in infants and children.J Pediatr Surg. 1989; 24: 70-76
- Optimal therapy for patients with biliary atresia: portoenterostomy (“Kasai” procedures) versus primary transplantation.J Pediatr Surg. 1990; 25: 153-162
- Liver transplantation in children.Ann Surg. 1991; 213: 48-57
- Indications for pediatric liver transplantation.J Pediatr. 1987; 111: 1039-1045
- Liver transplantation and the Kasai operation in biliary atresia.J Pediatr Surg. 1988; 23: 623-626
- A flexible procedure for multiple cadaveric organ procurement.Surg Gynecol Obstet. 1984; 158: 223-230
- The use of UW solution in clinical transplantation: a 4-year experience.Ann Surg. 1992; 215: 579-585
- Experience with reduced-size liver transplantation.Surg Gynecol Obstet. 1990; 171: 139-147
- The predictive value of donor liver biopsies for the development of primary nonfunction after orthotopic liver transplantation.Transplantation. 1991; 51: 157-163
- Long-term outcome after Surgery for biliary atresia: study of 40 patients surviving for more than 10 years.Gastroenterology. 1990; 99: 1793-1797
- The therapy of biliary atresia combining the Kasai portoenterostomy with liver transplantation: a single center experience.J Pediatr Surg. 1990; 25: 149-152
- The results of reduced size liver transplantation, including split livers, in patients with end-stage liver disease.Transplantation. 1992; 53: 387-391
- Orthotopic liver transplantation with a reduced-size graft: an ideal compromise in pediatrics?.Surgery. 1992; 111: 532-542
- Surgical techniques and innovations in living related liver transplantation.Ann Surg. 1993; 217: 82-91
- Orthotopic liver transplantation for biliary atresia: evolution of management.Arch Surg. 1988; 123: 1237-1239
- Liver transplantation for biliary atresia.in: Hoffman MA Current controversies in biliary atresia. RG Landes Company, Austin, Texas1992: 81-95
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
© 1993 Published by Elsevier Inc.