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. 2020 Oct 20;20(1):484.
doi: 10.1186/s12887-020-02355-8.

Relevant factors for early liver transplantation after Kasai portoenterostomy

Liang Ge  1 , Jianghua Zhan  2 , Wei Gao  3 , Shengqiao Zhao  1 , Xiaodan Xu  1 , Ran Dou  1
Affiliations

Relevant factors for early liver transplantation after Kasai portoenterostomy

Liang Ge et al. BMC Pediatr. .

Abstract

Background: To explore the relevant factors for early liver transplantation (LT) after Kasai portoenterostomy (KP).

Methods: Retrospective analysis was performed for 200 children with biliary atresia, who underwent LT with hepatic failure after KP. According to the interval between KP and LT, they were divided into three groups: G1 (≤6-month), G2 (6-month~ 2-year) and G3 (> 2-year). Gender, age of Kasai portoenterostomy, jaundice-clearance, cholangitis after KP and liver function indexes before LT were compared among the three groups.

Results: The proportion of patients with age of KP (≤90-day) in G1 was lower than that in G3 (P = 0.003). Jaundice-clearance occurred in 6 (7.6%), 26(28.6%) and 26 (86.7%) patients after KP in G1, G2 and G3 respectively (P < 0.001). There were statistical differences in the incidence of early cholangitis, late cholangitis and repeated cholangitis among the three groups (P = 0.035, < 0.001 and 0.022). The native liver survival (NLS) rate of children at operation age > 90-day was lower than that of children at operation age ≤ 90-day (P = 0.002). The NLS rate of the children with jaundice-clearance after KP was significantly better than that of the children without jaundice-clearance (P < 0.001). The NLS rate of the children with early cholangitis after operation was lower than that in children without early cholangitis (P = 0.026). The NLS rate of patients of G2 and G3 with cholangitis after KP was lower than that in children without cholangitis (P = 0.017). Multiple logistic regression analysis showed uncleared jaundice after KP was a risk factor for the NLS time in patients.

Conclusion: The age of KP (> 90-day), jaundice-unclear and early cholangitis could reduce the NLS time after KP, which were related to early liver transplantation. Jaundice-unclear was a risk factor for early liver transplantation.

Keywords: Biliary atresia; Kasai portoenterostomy; Liver transplantation; Relevant factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
NLS rate at different age of KP
Fig. 2
Fig. 2
NLS rate with or without jaundice clearance
Fig. 3
Fig. 3
NLS rate with or without early cholangitis
Fig. 4
Fig. 4
NLS rate with or without cholangitis(G2 and G3)
See this image and copyright information in PMC

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