Relevant factors for early liver transplantation after Kasai portoenterostomy

BMC Pediatrics

Jianghua Zhan¹  Wei Gao²  Xiaodan Xu³  Liang Ge³  Shengqiao Zhao³  Ran Dou³ 

[1] Department of Pediatric Surgery, Tianjin Children’s Hospital, LongYan Road 238, Beichen District, 300134, Tianjin, PR China;Department of Transplantation, Tianjin First Central Hospital, 300192, Tianjin, China;Graduate School of Tianjin Medical University, 300070, Tianjin, China;

关键词: Biliary atresia;    Liver transplantation;    Relevant factors;    Kasai portoenterostomy;   

DOI  :  10.1186/s12887-020-02355-8

来源: Springer

【 摘 要 】

BackgroundTo explore the relevant factors for early liver transplantation (LT) after Kasai portoenterostomy (KP).MethodsRetrospective 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.ResultsThe 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.ConclusionThe 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.

【 授权许可】

CC BY