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Comparison of Outcomes of Living Donor Liver Transplantation for Biliary Atresia Patients with and without Kasai Portoenterostomy

T. Kanmaz1, O. Andacoglu1, Y. Yankol2, C. Karatas1, N. Mecit1, K. Acarli3, M. Kalayoglu1

1Koc University, Istanbul, Turkey, 2University of Wisconsin, Madison, WI, 3Memorial Hospital, Istanbul, Turkey

Meeting: 2021 American Transplant Congress

Abstract number: 1168

Keywords: Biliary atresia, Liver transplantation, Living donor, Outcome

Topic: Clinical Science » Liver » Liver: Pediatrics

Session Information

Session Name: Liver: Pediatrics

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: We evaluated 10 year outcomes and the potential predictors of outcomes after living donor liver transplant (LT) for biliary atresia (BA) patients with and without Kasai portoeneterostomy (KPE).

*Methods: We retrospectively reviewed pediatric BA patients underwent living donor liver transplantation (LDLT) at Memorial Hospital, Istanbul, Turkey between 2006-2016. Univariate analysis and Kaplan Meier survival analyses were performed.

*Results: Out of 87 cases, ten-year survival rate was 68%. Patients with KPE (n=59) were significantly older (6,95 mo vs. 24,3, p<0.0001), had significantly lower preoperative INR, lower bilirubin, lower WBC, lower PELD, lower graft GRWR (all p< 0.05). Patients with KPE had significantly higher incidence of preoperative cholangitis (p=0.007). Ascites, peritonitis, variceal bleeding, encephalopathy were similar between patients with and without KPE. Post-operative vascular and biliary complication rates, length of ICU stay and total length of stay were similar between patients with and without Kasai (p>0.05). Although mortality rate was higher in no KPE group (42,8% vs. 27.1%) this was not significant (p>0.05) (Table 1). There was statistically significant improvement in survival for patients who had transplant at or after 8 months of age (fig 1). There was a survival benefit trend in KPE group but this was not statistically significant. None of the variables, other than age of transplant, were associated with survival.

*Conclusions: KPE is justified as evidenced by improved physiological parameters and lower PELD scores at LT. BA patients have better survival after LT when transplanted after 8 months independent from KPE status. Larger cohort is necessary to improve the findings of this study.

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To cite this abstract in AMA style:

Kanmaz T, Andacoglu O, Yankol Y, Karatas C, Mecit N, Acarli K, Kalayoglu M. Comparison of Outcomes of Living Donor Liver Transplantation for Biliary Atresia Patients with and without Kasai Portoenterostomy [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-outcomes-of-living-donor-liver-transplantation-for-biliary-atresia-patients-with-and-without-kasai-portoenterostomy/. Accessed March 26, 2023.

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