Factors influencing the outcome of liver transplantation for biliary atresia

Abstract

Background/Purpose: This study examined the factors present before liver transplantation (LTx) influencing the outcome in 14 patients who had biliary atresia (BA) who underwent LTx. Results: Nine patients survived (Group A), whereas five died primarily of infection (Group B). Rate of the attempted multiple hepatic portoenterostomy (HPE) and existence of intestinal stoma was significantly higher in Group B than in Group A. Pre-LTx parameters showed significant difference between the two groups as follows: total bilirubin, 15.9 ± 7.9 versus 29.1 ± 14.5 mg/dL ( P = .0446); gamma-glutamyl transpeptidase, 170.0 ± 97.6 versus 65.2 ± 38.8 IU/L ( P = .0425); the body weight deviation score, 0.17 ± 0.88 SD versus −1.46 ± 0.30 SD ( P = .0029); total cholesterol, 129.4 ± 33.5 versus 52.2 ± 20.4 mg/dL ( P = .0008) in Group A versus Group B. Total cholesterol level and body weight for age remained within normal range until the advanced stage and rapidly decreased according to deterioration of the general condition before LTx. Conclusions: From these results, avoidance of multiple HPE and closure of stoma before LTx may be preferable. LTx should be performed before failure to thrive or hypocholesterolemia develops.