ArticleScientific reports2021
Life long follow up and management strategies of patients living with native livers after Kasai portoenterostomy.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Comparison of different Kasai portoenterostomy techniques in the outcomes of biliary atresia: a systematic review and network meta-analysis.Pediatric surgery international · 2024Pooled it
- The characteristics of liver nodules in biliary atresia native liver survivors.Pediatric surgery international · 2026Article
- Standardised Transplant-Orientated Kasai Portoenterostomy in a Combined Kasai and Transplant Programme: An 11-Year Single-Surgeon Series of 74 Consecutive Cases.Journal of clinical medicine · 2026Article
- Diagnostic and management guidelines for biliary atresia in 2025.Hepatobiliary surgery and nutrition · 2026Review
- Association between post-Kasai cholangitis episodes, ursodeoxycholic acid regimen, and portal hypertension risk in biliary atresia: a multicenter cross-sectional study.Pediatric surgery international · 2026Article
- APSPGHAN Statement on Endoscopic Variceal Bleeding Hemostasis.Pediatric gastroenterology, hepatology & nutrition · 2026Review
- Establishment of Biliary Atresia Prognostic Classification System via Survival-Based Forward Clustering - A New Biliary Atresia Classification.Indian journal of pediatrics · 2025Article
- Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study.Pediatric surgery international · 2024Article
- Major surgical conditions of childhood and their lifelong implications: comprehensive review.BJS open · 2024Review
- Primary liver transplantationWorld journal of transplantation · 2024Article
- Diseases of bile duct in children.World journal of gastroenterology · 2024Review
- The prevalence and impact of small intestine bacterial overgrowth in biliary atresia patients.Pediatric research · 2024Article
- Long-term clinical and socioeconomic outcomes of children with biliary atresia.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- Cost-effectiveness analysis of liver transplantation in biliary atresia according to the severity of end-stage liver disease.BMC pediatrics · 2023Article
- Treatment of intractable cholangitis in children with biliary atresia: Impact on outcome.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023Article
- Clinical Characteristics and Outcome of Infants with Biliary Atresia in Bahrain.Oman medical journal · 2023Article
- Biliary Atresia in Adolescence and Adult Life: Medical, Surgical and Psychological Aspects.Journal of clinical medicine · 2023Review
- Developing Biliary Atresia-like Model by Treating Human Liver Organoids with Polyinosinic:Polycytidylic Acid (Poly (I:C)).Current issues in molecular biology · 2022Article
- Cholangitis Definition and Treatment after Kasai Hepatoportoenterostomy for Biliary Atresia: A Delphi Process and International Expert Panel.Journal of clinical medicine · 2022Article
- Comprehensive Analysis of Gut Microbiota and Fecal Bile Acid Profiles in Children With Biliary Atresia.Frontiers in cellular and infection microbiology · 2022Article
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We present a 37 years' experience in the management of biliary atresia (BA) and discuss long-term complications after Kasai portoenterostomy (KPE). A retrospective territory-wide study from 1980 to 2017 on 231 patients with open KPE from three tertiary paediatric surgical centres was performed. Outcome parameters were clearance of jaundice (COJ), native liver survival (NLS) and long-term complications. Factors affecting the operative outcomes were analyzed. The median duration of follow up was 17.5 (IQR: 13.5-22) years. Over 66% of patients became jaundice-freed at 1 year after KPE. Seventy patients (30.3%) received liver transplant (LT) at a median age of 6.2 (IQR: 4.3-8.4) years. The NLS rates at 10 and 20 years were 70.7% and 61.5% respectively with no significant change over the study period. The median age at KPE was 59 (IQR: 49-67) days. KPE performed before 70 days was associated with higher odd ratios for successful drainage but the age of KPE did not have an impact on the long-term NLS. Among all native liver survivors (n = 153), the median bilirubin level was 24 (IQR: 16-36) µmol/L. Portal hypertension (PHT) and recurrent cholangitis were found in 51.6% and 27.5% of them respectively. With a vigilant follow up program, more than 60% of BA patients could remain stable with the disease and achieve long-term survival without LT. Although cholestasis, portal hypertension and recurrent cholangitis are common in long-term NLS, with a comprehensive follow management strategy, they do not always necessitate LT. Our study serves as an example for countries where deceased donor organs are scarce due to very low donation rate.
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