The effects of Kasai procedure on the liver transplantation for biliary atresia

Abstract

Objective To explore the effects of Kasai procedure on the for liver transplantation for biliary atresia.Methods Retrospective analysis was performed for the clinical data of 86 children with cholestatic cirrhosis who required liver transplantation for biliary atresia.They were divided into non-Kasai and Kasai groups.And two groups were compared with regards to onset time of jaundice,Kasai surgery age,postoperative jaundice fading,frequency of cholangitis,transplantation age,operative duration and relevant laboratory parameters.Results Non-Kasai group:the average age of liver transplantation was 310.9 days (174-1 285) and average transplantation time 9 h 17 min (6 h-12 h15 min); Kasai group:the average age of transplantation was 549.5(173-3 100) days and the average surgical duration 8 h 40 min (5 h 15 min-14 h).Significant inter-group differences existed in transplantation age and surgical duration (P＜0.05); for different Kasai age groups,transplantation operative duration was significantly different.Among the age group of 31-60 days,the clearance rate of jaundice was quite high,there were fewer bouts of cholangitis and the least number of transplantation within 1 year and the age of transplantation was the oldest.The values of aspartate transaminase (AST),total bilirubin (TBIL),direct bilirubin (DBIL) and indirect bilirubin (IBIL) in Kasai group were significantly lower than those in non-Kasai group.And the differences were significant (P＜0.05).For TORCH virus detection,the virus positive rates of Kasai group were lower than those of non-Kasai group.But there was a higher blood bacterial infection.Both groups had severe liver fibrosis,Kasai group had obvious bile duct hyperplasia while cholestasis was more severe in non-Kasai group.Conclusions Kasai surgery may improve the clinical symptoms of biliary atresia,alleviate liver damage,decrease liver transplantation surgical duration and reduce the risk of liver transplantation.Thus it plays protective roles in successful liver transplantation. Key words: Biliary atresia; Kasai surgery; Liver transplantation