Living donor liver transplantation for post-Kasai biliary atresia: Analysis of pretransplant predictors of outcomes in infants.

摘要: After decades of dramatic surgical innovations in pediatric living donor liver transplantation (LDLT), LDLT for biliary atresia (BA) still poses various challenges. This study reviewed our experience with children post-Kasai BA and evaluated outcomes prognostic factors. From 2005 to 2016, 168 patients were enrolled divided into 3 groups by age. Patient characteristics perioperative data compared. Predictors morbidity mortality following analyzed 93 infants. Outcome was relatively worse infants than older children, overall survival at 1 5 years 94.5% 93.2%, respectively, graft 91.1% each. Incidence vascular complications not significantly higher High Pediatric End-Stage Liver Disease (PELD) score (odds ratio [OR], 3.72; 95% confidence interval [CI], 1.30-10.67; P = 0.02) portal vein (PV) hypoplasia (OR, 3.23; CI, 1.10-9.52; P = 0.03) independent risk factors morbidity. Low weight-for-age z (hazard ratio, 5.76; 1.05-31.47; identified as a significant factor after LDLT, but age or absolute body weight (BW). Infants BW deficit had smaller PV diameter (P = 0.005), greater blood loss (P = 0.001), incidence postoperative bacteremia (P = 0.01). In conclusion, high PELD morbidity, associated poor LDLT. However, these the earliest possible time referral is feasible option excellent patient an experienced center. Transplantation 23 1199-1209 2017 AASLD.