The influence of portoenterostomy on transplantation for biliary atresia

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Brendan C VisserRyutaro Hirose

Abstract

After portoenterostomy (PE) for biliary atresia (BA), many patients suffer progressive deterioration of liver function and ultimately require liver transplantation. We retrospectively reviewed a single center's experience with pediatric liver transplantation for BA from 1988 to 2002. Sixty-six patients underwent 69 liver transplants for BA. Forty-two (63%) patients had previously undergone Kasai PE, 11 (17%) biliary appendicoduodenostomy (BAD), and 13 (20%) had no prior biliary drainage (NBD). The BAD procedure offered only short-term biliary drainage--the mean interval between PE and transplant was more than twice that for Kasai patients than for BAD patients (132 versus 49 weeks). The transplants included 11 cadaveric partial, 27 cadaveric whole, and 31 living related transplants. Three patients required retransplant. Prior PE did not increase the incidence of major perioperative complications or unplanned reexploration. After transplant, the 1-, 5-, and 10-year actuarial graft survival rates were 87%, 86%, and 80%, respectively. The 1-, 5-, and 10-year actuarial patient survival rates were 91%, 89%, and 83%. PE remains an important bridge to transplant. In conclusion, transplantation for BA offers excellent long-term graft a...Continue Reading

References

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Citations

Aug 29, 2013·Pediatric Surgery International·Masaki NioAtsushi Okamura
Mar 28, 2013·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Taizen UrahashiKoichi Mizuta
Jan 11, 2016·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Panliang WangWei Cai
Sep 24, 2015·Journal of Pediatric Surgery·Patrick Ho Yu ChungPaul Kwong Hang Tam
Sep 10, 2008·Journal of Pediatric Surgery·Robert A CowlesDominique M Jan
Jul 22, 2008·Journal of Pediatric Surgery·Magd A Kotb
Feb 12, 2008·Transplantation Proceedings·H KarakayaliM Haberal
Dec 27, 2005·Clinics in Liver Disease·Claus Petersen
Aug 31, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C-L ChenH-L Eng
Apr 3, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Joao Seda NetoPaulo Chapchap
Jul 5, 2006·Journal of Pediatric Surgery·Barbara A HaberElizabeth B Rand
Jul 8, 2016·Pediatric Transplantation·Mohamed SafwanMohamed Rela
Sep 4, 2016·Journal of Hepato-biliary-pancreatic Sciences·Chiyoe ShirotaHisami Ando
Sep 22, 2016·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shikha S SundaramRonald J Sokol
Jan 12, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Chih-Yang HsiaoPo-Huang Lee
Jan 25, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Virginie FouquetOlivier Soubrane

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