Treatment of Biliary Atresia by Portoenterostomy and Liver Transplantation: The Queen Mary Hospital, Hong
Kong Experience
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HTUT SAING, SHEUNG TAT FAN,
KWONG LEUNG CHAN, WILLIAM
WEI, GEORGE HLAING MYA,
CHUNG MAU LO and WEI
CHENG
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Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong
Ninety three out of 96 patients with biliary atresia (BA) underwent Kasai 1 portoenterostomy and 11 children
subsequently underwent 12 liver transplantation (LTX) procedures which included 8 living related liver transplants
(LRLT), 3 reduced-size liver transplants (RSLT) and 1 orthotopic liver transplantation (OLT). During a follow-up
period of 3-206 months (mean, 73 months) after portoenterostomy and 3-63 months after LTX, 50% of 96 patients
are alive and well with total clearance of jaundice while 12% are mildly jaundiced, 10% are deeply jaundiced and
28% have died. Two of the 3 patients who did not undergo portoenterostomy and 25 from the portoenterostomy
group have died. Of the latter group, 22 deaths occurred before, and 3 after the introduction of LTX therapy
respectively. Of the 68 long-term survivors, 32 are less than 5, and 36 are 6-17 years old. Complete clearance of
jaundice was achieved in 55% of patients irrespective of whether portoenterostomy was initially performed at
<10 or between 10 and 12 weeks. Portoenterostomy performed beyond 13 weeks was associated with declining
results. We conclude that (1) portoenterostomy com-bined with liver transplantation, when indicated, has given
patients with BA a much better prognosis and (2) pediatric LTX in our institute is a well established procedure
with 100% patient and 88% primary graft survival.
Key word(s)---
biliary atresia; portoenterostomy; liver transplantation; microvascular surgery
Tohoku J. Exp. Med., 1997, 181, 109-116
Address for reprints:
Professor Htut Saing, Chief, Division of Paediatric Surgery, Department of Surgery, The University of Hong
Kong, Queen Mary Hospital, Hong Kong.
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