scholarly journals Impact of Kasai procedure and the length of native liver survival time on outcomes of liver transplantation for biliary atresia

2021 ◽  
Author(s):  
Liwei Liu ◽  
Lin Wei ◽  
Wei Qu ◽  
Ying Liu ◽  
Zhigui Zeng ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Atresia ◽  
Survival Time ◽  
Kasai Procedure ◽  
Native Liver ◽  
Native Liver Survival

scholarly journals Biliary atresia screening in Shenzhen: implementation and achievements

2020 ◽  
Vol 105 (8) ◽  
pp. 720-723 ◽  
Author(s):  
Jiachen Zheng ◽  
Yongqin Ye ◽  
Bin Wang ◽  
Lihui Zhang
Keyword(s):  
Survival Rate ◽  
Biliary Atresia ◽  
Screening Programme ◽  
Age At Diagnosis ◽  
Considerable Influence ◽  
Kasai Procedure ◽  
Native Liver ◽  
The Government ◽  
Free Rate ◽  
Native Liver Survival

ObjectiveTo elaborate on the implementation and achievements of a biliary atresia (BA) screening programme in Shenzhen.MethodsIn 2015, we partnered with the government in Shenzhen and attached the stool colour card (SCC) to the health handbook for mothers and children. These handbooks have been distributed through official channels to every pregnant woman in Shenzhen since 1 January 2015. A total of 118 patients diagnosed with BA at Shenzhen Children’s Hospital were enrolled and divided into two cohorts based on their date of diagnosis: cohort A before and cohort B after introduction of screening. The cohorts were compared to evaluate differences in age at diagnosis, jaundice-free rate, 2-year native liver survival rate and so on.ResultsAfter the implementation of the screening programme, the age at diagnosis decreased from 81±12 to 56±15 days old (p<0.05), the incidence of postoperative complications decreased from 58.8% to 52.6% (p<0.05), the jaundice-free rate increased from 47.1% to 54.4% (p<0.05), and the 2-year native liver survival rate increased from 44.4% to 52.6% (p<0.05). The percentage of patients who underwent surgery increased from 68.0% to 83.8% (p<0.05).ConclusionIn Shenzhen, our screening programme led to earlier diagnoses and better prognoses. The latter resulted in an increased willingness to undergo the Kasai procedure. Through a hospital and government collaboration, this programme exerted a considerable influence, and guardians observed benefits with only a small cost of implementation. Our results may eventually help promote the widespread use of the SCC across the whole country.

scholarly journals Does the Treatment After Kasai-Procedure Influence Biliary Atresia Outcome and Native Liver Survival?

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Andrea Pietrobattista ◽  
Antonella Mosca ◽  
Daniela Liccardo ◽  
Tommaso Alterio ◽  
Chiara Grimaldi ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Kasai Procedure ◽  
Native Liver ◽  
Native Liver Survival

Kasai Procedure in Patients Older Than 90 Days: Worth a Cut

2021 ◽  
Author(s):  
Marie Uecker ◽  
Joachim F. Kuebler ◽  
Nagoud Schukfeh ◽  
Eva-Doreen Pfister ◽  
Ulrich Baumann ◽  
...  
Keyword(s):  
Treatment Option ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Primary Treatment ◽  
Inclusion Criteria ◽  
Bridge To Transplant ◽  
Kasai Procedure ◽  
Native Liver ◽  
Native Liver Survival

Abstract Introduction Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE. Materials and Methods A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90–133 days). Results Postoperative jaundice clearance (bilirubin < 2 mg/dL) at 2-year follow-up was achieved in three patients (27%). Eight patients (73%) received a liver transplant at a mean of 626 days (range: 57–2,109 days) after KPE. Four patients (36%) were transplanted within 12 months post-KPE. Two patients died 237 and 139 days after KPE due to disease-related complications. One patient is still alive with his native liver, currently 10 years old. Conclusion Even when performed at an advanced age, KPE can help prolong native-liver survival in BA patients and offers an important bridge to transplant. In our opinion, it continues to represent a viable primary treatment option for late-presenting infants with BA.

Long-term outcome and necessity of liver transplantation in infants with biliary atresia are independent of cytokine milieu in native liver and serum

Cytokine ◽  
2018 ◽  
Vol 111 ◽  
pp. 382-388 ◽  
Author(s):  
Omid Madadi-Sanjani ◽  
Joachim F. Kuebler ◽  
Stephanie Dippel ◽  
Anna Gigina ◽  
Christine S. Falk ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Atresia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Native Liver ◽  
Cytokine Milieu

scholarly journals Quantitative Liver Fibrosis Using Collagen Hybridizing Peptide to Predict Native Liver Survival in Biliary Atresia

2020 ◽  
Vol 70 (1) ◽  
pp. 87-92
Author(s):  
Catalina Jaramillo ◽  
Stephen L. Guthery ◽  
Amy Lowichik ◽  
Gregory Stoddard ◽  
Taegun Kim ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Biliary Atresia ◽  
Native Liver ◽  
Native Liver Survival

Liver transplantation following the Kasai procedure in treatment of biliary atresia: a single institution analysis

2014 ◽  
Vol 30 (9) ◽  
pp. 871-875 ◽  
Author(s):  
Hideyuki Sasaki ◽  
Hiromu Tanaka ◽  
Motoshi Wada ◽  
Takuro Kazama ◽  
Kotaro Nishi ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Atresia ◽  
Single Institution ◽  
Kasai Procedure

scholarly journals Relevant factors for early liver transplantation after Kasai portoenterostomy

2020 ◽  
Author(s):  
Liang Ge ◽  
Jianghua Zhan ◽  
Wei Gao ◽  
Shengqiao Zhao ◽  
Xiaodan Xu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Regression Analysis ◽  
Risk Factor ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Kasai Portoenterostomy ◽  
Native Liver ◽  
Native Liver Survival ◽  
Relevant Factors ◽  
Better Than

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 survival 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.

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