Determinants of Life Span after Kasai Operation at the Era of Liver Transplantation
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FRÉDÉRIC GAUTHIER1,
JEAN-LUC LUCIANI1,
CHRISTOPHE CHARDOT1,
SOPHIE BRANCHEREAU1,
OLIVIER de DREUZY1,
ABDULRAHMAN LABABIDI1,
PHILIPPE MONTUPET1,
ANNE-MARIE
DUBOUSSET2, GILBERT
HUAULT3, OLIVIER
BERNARD4 and JACQUES
VALAYER1
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1Service de Ghirurgie Pédiatrique, 2Départment d'Anesthésie-Réa
nimation, 3UnitEde Soins Intensifs pour Enfants, 4Service d'Hép
atologic Pédiatrique, Centre Hospitalier Universitaire Bicêtre, FacultEde Médecine Paris Sud,
UniversitEParis 11, Le Kremlin Bicêtre, France
The aim of this work is to determine the influence of age, extrahepatic biliary lesions pattern
(EHBP) and association to polysplenia syndrome (PS) on 10 years outcome of 164 patients
with biliary atresia (BA) treated from 1984 to 1992 by initial Kasai operation (KO) and
secondary liver transplantation (LT) when necessary. Actuarial crude survival without or
after LT(CS), actuarial survival with native liver (NLS) and jaundice-free actuarial survival
with native liver (JFS) were calculated from I to 10 years versus age (under/over 45 days),
EHBP (favorable/ unfavorable) and PS (no/yes). Overall 10-year CS is 70%, overall 10-year
NLS and JFS are 14%. In univariate analysis, age at KO under 46 days, favorable EHBP (BA
with patent gallbladder, and/or cystic dilatation of extrahepatic bile duct, or BA restricted to
choledocus), and absence of PS are significant determinants of a better outcome regarding
CS, NLS and JFS. EHBP is more discriminant than age. Influence of PS in this series is
redundant with that of EHBP since 11/11 patients with PS had unfavorable EHBP.
Key word(s)---
biliary atresia; surgery; liver transplantation
Tohoku J. Exp. Med., 1997, 181, 97-107
Address for reprints:
Professeur Frédéric Gauthier, Service de Chirurgie Pédiatrique, Centre Hospitalier
Universitaire Bicêtre 78, rue du Général Leclerc F94275 Le Kremlin Bicêtre Cedex France.
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