[Should the medico-surgical strategy for biliary atresia be changed in view of liver transplantation as a reality?].
Biliary atresia (BA) is the main source of candidates for paediatric liver transplantation (PLTx) with 64 per 100 of survival. The follow-up of 35 immediate candidates of BA, 19 of them transplanted, induced to the authors to change some details on the BA treatment. This disorder does not finish already with portoenterostomy. Eventually mortality causes are infection and chronic rejection. The functional loss of jejunal segment in the Roux en Y may explain the poor cyclosporin absorption and therefore chronic rejection. By other hand, chronic malnutrition presented by these patients before PLTx may favour infection. Authors recommend more aggressive medical treatment before PLTx and technical improvement in the portoenterostomy with the aim of previous surgery does not difficult posterior PLTx.
Martínez Ibáñez
V
V
Departamento de Cirugía Pediátrica, Hospital Materno-Infantil Valle Hebrón, Barcelona.
Infante Pina
D
D
Broto Mangues
J
J
Tormo Carnicer
R
R
Lloret Roca
J
J
Boix Ochoa
J
J
D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D011183:Postoperative Complications
Debe cambiar la estrategia medico-quirúrgica de la atresia biliar ante la realidad del trasplante hepático?