Liver transplantation in Japanese and Australian/New Zealand children with biliary atresia: a 10-year comparative study.
OBJECTIVE
To compare Japanese with Australian/New Zealand (ANZ) children with biliary atresia who were treated by liver transplantation, and evaluate the indications for and timing of transplantation.


METHODS
Retrospective study.


METHODS
Queensland Liver Transplant Service (QLTS), Australia.


METHODS
43 Japanese and 30 ANZ children with biliary atresia who required transplantation between 1985 and 1992.


METHODS
The 43 Japanese children had 52 transplants, and the 30 ANZ children had 33.


METHODS
Morbidity, mortality, and long term survival.


RESULTS
The Japanese children had significantly lower serum albumin concentrations than the ANZ children preoperatively (mean (SD) 32 (7) g/L compared with 37 (5), p<0.05). The actuarial survival at 7 years of the ANZ children was significantly higher than that of the Japanese children (79% compared with 49%, p<0.05). There were 24 deaths (17 Japanese, 40%, and 7 ANZ, 23%); 2 of the ANZ and 7 of the Japanese children died more than a year after transplantation. All 26 children who were well-nourished at the time of transplantation defined as a Z-score (weight or height minus mean weight or height for age, sex, and race, divided by the SD) of -1 or more were alive at 1 month compared with 11 of the 47 poorly-nourished children (Z-score <-1). Survival among the Japanese declined after 1 year, and there was no association with Z-scores. Overall, Z-scores for weight improved significantly after transplantation, whereas those for height improved a little, but not significantly so. Japanese children were significantly shorter than ANZ children, and their Z-scores for height did not improve after transplantation.


CONCLUSIONS
liver transplantation should be done as soon as possible for children with biliary atresia to maximise survival and growth.
Ishikawa
M
M
The Queensland Liver Transplantation Service, Brisbane, Australia.
Lynch
S V
SV
Balderson
G A
GA
Shepherd
R W
RW
Ong
T H
TH
Strong
R W
RW
D000293:Adolescent; D001315:Australia; D001656:Biliary Atresia / Q000601:surgery*; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007564:Japan; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D009520:New Zealand; D009752:Nutritional Status; D011183:Postoperative Complications; D011793:Queensland; D012189:Retrospective Studies; D013997:Time Factors