Identification of clinical and laboratory factors predictive of long term-native liver survival after Kasai portoenterostomy

Purpose: This study explored pre- and post-operative predictive factors for long-term native liver survival (NLS) in patients with biliary atresia (BA) after Kasai hepatoportoenterostomy (KPE). Methods: We retrospectively reviewed 50 consecutive patients with BA between January 1990 and December 202...

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Main Authors: Takashi Kobayashi, Yoshiaki Kinoshita, Toshiyuki Ohyama, Yuhki Arai, Yu Sugai, Koichi Saito, Yu Hamasaki
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Journal of Pediatric Surgery Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949711625000255
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Summary:Purpose: This study explored pre- and post-operative predictive factors for long-term native liver survival (NLS) in patients with biliary atresia (BA) after Kasai hepatoportoenterostomy (KPE). Methods: We retrospectively reviewed 50 consecutive patients with BA between January 1990 and December 2023 at our institute after excluding those with splenic malformations. We analyzed the prognostic factors at pre-KPE, 30 days and 6 months after KPE for a long-term NLS. Results: Of the 50 patients, 25 survived with their native liver, and 25 showed native liver failure over a median 109 (2–395) months. A multivariable analysis showed that early age (≤56 days old) at KPE was a predictive factor for an NLS (odds ratio [OR]: 5.43, 95 % confidence interval [CI] 1.04–28.30; p = 0.045). Serum total bilirubin (≤3.5 mg/dl) at 30 days (OR: 9.31, 95 % CI 1.57–55.07; p = 0.014) and bile acid (≤49.6 nmol/ml) at 6 months after KPE were predictive factors for an NLS (OR: 35.33, 95 % CI 1.82–686.03; p = 0.019). Conclusion: KPE for BA should be performed early (≤56 days old) for an NLS. Serum total bilirubin ≤3.5 mg/dl at 30 days and bile acid ≤49.6 nmol/ml at 6 months after KPE were predictive factors for an NLS.
ISSN:2949-7116