P022 Can we change the outcome of biliary atresia and native liver survival without prophylactic antibiotic therapy after Kasai procedure? A single-center experience

2018 ◽  
Vol 50 (4) ◽  
pp. e366-e367
Author(s):  
D. Liccardo ◽  
C. Grimaldi ◽  
A. Pietrobattista ◽  
M.S. Basso ◽  
A. Mosca ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Biliary Atresia ◽  
Prophylactic Antibiotic ◽  
Single Center ◽  
Single Center Experience ◽  
Kasai Procedure ◽  
Native Liver ◽  
Prophylactic Antibiotic Therapy ◽  
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.

Management of biliary atresia in the liver transplantation era: A 15-year, single-center experience

1998 ◽  
Vol 33 (1) ◽  
pp. 115-118 ◽  
Author(s):  
Joäo Gilberto Maksoud ◽  
Dario O Fauza ◽  
Marcos M Silva ◽  
Gilda Porta ◽  
Irene Miura ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Biliary Atresia ◽  
Single Center ◽  
Single Center Experience
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