Native liver survival and related factors of biliary atresia: a single center′s experiences with 357 cases
10.3760/cma.j.cn101070-20250318-00176
- VernacularTitle:单中心357例胆道闭锁自体肝生存状况及相关因素分析
- Author:
Jie DONG
1
;
Bo LI
;
Yong XIAO
;
Ming LI
;
Tidong MA
;
Ting XIE
;
Guang XU
;
Chanjuan ZOU
;
Renpeng XIA
;
Chonggao ZHOU
Author Information
1. 中南大学湘雅医学院附属儿童医院（湖南省儿童医院）儿科医学研究所，长沙 410007
- Publication Type:Journal Article
- Keywords:
Biliary atresia;
Probability of native liver survival;
Rate of native liver survival;
Perioperative related factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2025;40(12):915-920
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To describes the probability and rate of native liver survival (NLS) in biliary atresia (BA) patients after Kasai portoenterostomy (KPE)over various time periods and analyzes the perioperative factors associated with liver transplantation or death.Methods:A retrospective case-summary.BA patients administrated at the Department of Fetal and Neonatal Surgery in Hunan Children′s Hospital between January 2015 and December 2021.Probability and rate of NLS were calculated by life table.Cox proportional hazards regression model and Logistic model was applied to explore the perioperative factors related to post-Kasai liver transplantation/death.Results:The median age at Kasai surgery was 62 days.The rate of jaundice clearance (JC) was 64.5% within 3 months after Kasai, and 58.3% of the patients had cholangitis.The probability of NLS reached its lowest point in the first 1 year after Kasai (76.2%) and ranged from 93.2% to 98.0% in years 2-8 after Kasai.The rates of NLS in 2 years, 5 years and 8 years were 71.1%, 62.8% and 56.0%, respectively.Cytomegalovirus (CMV) infection before or on the day of Kasai without antiviral treatment can increase the risk of liver transplantation or death[ HR(95% CI): 1.628 (1.081-2.452), P=0.020].Preoperative gamma-glutamyl transferase increased the risk of liver transplantation/death within 1 year after Kasai[ OR(95% CI): 1.001 (1.000-1.001), P=0.021], and early cholangitis was a risk factor for liver transplantation/death within 5 years after Kasai[ OR(95% CI): 1.934 (1.004-3.726), P=0.048].JC within 3 months post-KPE was a protective factor of NLS. Conclusions:The first year after Kasai was the highest risk period for liver transplantation/death, which should be the focus of follow-up management.JC within 3 months after surgery is the protective factor for overall NLS, 1-year NLS and 5-year NLS.
