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Article
October 1988

Orthotopic Liver Transplantation for Biliary AtresiaEvolution of Management

Author Affiliations

From the Department of Surgery, UCLA School of Medicine.

Arch Surg. 1988;123(10):1237-1239. doi:10.1001/archsurg.1988.01400340063011
Abstract

• Forty-five patients with biliary atresia were accepted for orthotopic liver transplantation. Nine patients died awaiting transplantation, and 36 underwent transplantation. A portoenterostomy had been performed in 28 of these 36 patients, and its presence did not significantly affect the intraoperative blood loss (5.6 vs 4.1 blood volumes), the need for retransplantation (21% vs 12%), biliary complications (21% vs 12%), postoperative infections (36% vs 25%), or survival (82% vs 63%). These results indicate that early portoenterostomy is appropriate early therapy for biliary atresia; however, prompt referral to a liver transplant center for evaluation at the first sign of cholestasis is needed to attain optimal results for transplantation. Revisions of the portoenterostomy prior to transplantation did not improve the longevity of the procedure but did substantially increase complications and death after orthotopic liver transplantation.

(Arch Surg 1988;123:1237-1239)

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