Predictors of Need for Liver Transplantation in Children Undergoing Hepatoportoenterostomy for Biliary Atresia
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Read the article on jpedsurg.org ↗Article · Mar 2019 · 1 min read
In brief
In brief
Retrospective study of 81 biliary atresia patients undergoing hepatoportoenterostomy identifies elevated total bilirubin >2mg/dL as a significant predictor of subsequent liver transplantation need. With 44% requiring transplant at median 8.9 months post-procedure and 10-year transplant-free survival of 36%, findings suggest bilirubin levels may guide prognosis and transplant planning.
Written by the GCMD Library team from the article.
Purpose
The purpose of this study was to determine perioperative risk factors for need of liver transplantation following hepatoportoenterostomy.
Methods
A retrospective review of patients undergoing hepatoportoenterostomy for biliary atresia at our institution from 1990 to 2016 was completed.
Results
A total of 81 patients were identified with a median age of 51 days (IQR: 33-68) at hepatoportoenterostomy and a median follow-up time of 5.7 years (IQR: 1-11.6). Ten-year overall survival was 93% (95% CI: 84-97). Thirty-six patients (44%) ultimately required transplantation at a median time from hepatoportoenterostomy of 8.9 months (IQR: 5.2-19). The 10-year transplant-free survival was 36% (95%CI: 24-49). Steroid use (N=42) was not associated with improved 10-yr transplant-free survival (33% vs. 38%, p=0.690). Age at hepatoportoenterostomy was not significantly associated with the need for transplantation. Multivariable logistic regression analysis demonstrated that total bilirubin >2mg/dL (OR: 97, p