Predictors of Need for Liver Transplantation in Children Undergoing Hepatoportoenterostomy for Biliary Atresia

The purpose of this study was to determine perioperative risk factors for need of liver transplantation following hepatoportoenterostomy. A retrospective review of patients undergoing hepatoportoenterostomy for biliary atresia at our institution from 1990 to 2016 was completed. A total of 81 patient...

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Bibliographic Details
Published in:Journal of pediatric surgery 2019-06, Vol.54 (6), p.1127-1131
Main Authors: Ramos-Gonzalez, Gabriel, Elisofon, Scott, Dee, Edward C., Staffa, Steven J, Medford, Shawn, Lillehei, Craig, Kim, Heung Bae
Format: Article
Language:English
Subjects:
Biliary atresia
Hepatoportoenterostomy
Kasai procedure
Transplant-free survival
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Summary:The purpose of this study was to determine perioperative risk factors for need of liver transplantation following hepatoportoenterostomy. A retrospective review of patients undergoing hepatoportoenterostomy for biliary atresia at our institution from 1990 to 2016 was completed. A total of 81 patients were identified with a median age of 51 days (IQR: 33-68) at hepatoportoenterostomy and a median follow-up time of 5.7 years (IQR: 1-11.6). Ten-year overall survival was 93% (95% CI: 84-97). Thirty-six patients (44%) ultimately required transplantation at a median time from hepatoportoenterostomy of 8.9 months (IQR: 5.2-19). The 10-year transplant-free survival was 36% (95%CI: 24-49). Steroid use (N=42) was not associated with improved 10-yr transplant-free survival (33% vs. 38%, p=0.690). Age at hepatoportoenterostomy was not significantly associated with the need for transplantation. Multivariable logistic regression analysis demonstrated that total bilirubin >2mg/dL (OR: 97, p
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2019.02.051