Impact of previous multiple portoenterostomies on living donor liver transplantation for biliary atresia.
OBJECTIVE
The present study examined the impact of portoenterostomy on the morbidity and mortality of patients who later underwent living donor liver transplantation for biliary atresia.


METHODS
Sixty-one consecutive patients from January 1996 to May 2001 were analyzed. They were divided into two groups according to the number of previous portoenterostomies: once (group A, n=26) and twice or more (group B, n=35). Preoperative status, mortality, morbidity, hospital duration and survival were examined and compared between the groups.


RESULTS
Preoperative parameters regarding liver function and urgency status were comparable between the groups. The operation duration tended to be longer in group B than in group A (p=0.07). The blood loss and transfusion volumes in group B were greater than those in group A (p=0.03 for both comparisons). Vascular complications tended to be more frequent in group B patients. However, this difference was not significant (12% vs. 29%, p=0.06). The duration of hospitalization was longer in group B (p=0.04). Survival rates were comparable between the groups.


CONCLUSIONS
Our surgical results suggest that multiple previous portoenterostomies might have negative short-term effects in patients who undergo living donor liver transplantation for biliary atresia.
Sugawara
Yasuhiko
Y
Liver Transplant Team, University of Tokyo, Japan. yasusuga-tky@umin.ac.jp
Makuuchi
Masatoshi
M
Kaneko
Junichi
J
Ohkubo
Takao
T
Mizuta
Koichi
K
Kawarasaki
Hideo
H
D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007902:Length of Stay; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D011171:Portoenterostomy, Hepatic; D012086:Reoperation; D016896:Treatment Outcome