F. Gauthier et al., DETERMINANTS OF LIFE-SPAN AFTER KASAI OPERATION AT THE ERA OF LIVER-TRANSPLANTATION, Tohoku Journal of Experimental Medicine, 181(1), 1997, pp. 97-107
The aim of this work is to determine the influence of age, extrahepati
c biliary lesions pattern (EHBP) and association to polysplenia syndro
me (PS) on 10 years outcome of 164 patients with biliary atresia (BA)
treated from 1984 to 1992 by initial Kasai operation (KO) and secondar
y liver transplantation (LT) when necessary. Actuarial crude survival
without or after LT(CS), actuarial survival with native liver (NLS) an
d jaundice-free actuarial survival with native liver (JFS) were calcul
ated from 1 to 10 years versus age (under/over 45 days), EHBP (favorab
le/unfavorable) and PX (no/yes). Overall 10-year CS is 70%, overall 10
-year NLS and JFS are 14%. In univariate analysis, age at KO under 46
days, favorable EHBP (BA with patent gallbladder, and/or cystic dilata
tion of extrahepatic bile duct, or BA restricted to choledocus), and a
bsence of PS are significant determinants of a better outcome regardin
g CS, NLS and JFS. EHBP is more discriminant than age. Influence of PX
in this series is redundant with that of EHBP since 11/11 patients wi
th PS had unfavorable EHBP.