title: Urgent liver transplantation for biliary atresia: the experience in Bicêtre.
abstract: According to French rules for cadaver organ sharing, children with biliary atresia (BA) complicated with acute necrosis (ALN) can be registered on the waiting list for liver transplantation (LT) in a special intermediate grade urgent code. Over a 7 years period, 100 children have been submitted to elective LT for BA and 15 to urgent LT. Urgent procedures accounted for 25% of LT for BA in patients aged 0-2 years and 67% (8/12) in patients under 1 year of age. Children actuarial survival at 1, 12 and 48 months was respectively 66%, 60% and 60% versus 92%, 86% and 85%, deaths occurring earlier in the urgent group. Graft actuarial survival at 1, 12 and 48 months were 60%, 53% and 53% versus 85%, 77% and 76% (p < 0.05), respectively. Outcome of children and grafts after LT is not significantly different in BA cases and in other urgent indications, excluding retransplantations. In a LT program based on cadaver organ donation, allocation of in an urgent registration code to children with BA and ALN offers them more than 50% chance to escape death and does not result in wasting of grafts.
authors.affiliation: Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire Bicêtre, Faculté de Médecine Paris Sud, Université Paris 11, Le Kremlin Bicêtre, France.
authors.forename: F
authors.initials: F
authors.lastname: Gauthier
authors.forename: C
authors.initials: C
authors.lastname: Chardot
authors.forename: S
authors.initials: S
authors.lastname: Branchereau
authors.forename: Y
authors.initials: Y
authors.lastname: Okawa
authors.forename: O
authors.initials: O
authors.lastname: de Dreuzy
authors.forename: D
authors.initials: D
authors.lastname: Jacolot
authors.forename: D
authors.initials: D
authors.lastname: Devictor
authors.forename: D
authors.initials: D
authors.lastname: Debray
authors.forename: J
authors.initials: J
authors.lastname: Valayer
mesh_terms: D000206:Actuarial Analysis; D000367:Age Factors; D001656:Biliary Atresia / Q000473:pathology / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D011171:Portoenterostomy, Hepatic; D011183:Postoperative Complications; D015996:Survival Rate; D016896:Treatment Outcome