• 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)
Millis JM, Brems JJ, Hiatt JR, et al. Orthotopic Liver Transplantation for Biliary Atresia: Evolution of Management. Arch Surg. 1988;123(10):1237–1239. doi:10.1001/archsurg.1988.01400340063011
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: