Preoperative risk factors for the early failure of the Kasai portoenterostomy in patients with biliary atresia

Retrospective study of 58 biliary atresia patients identifies preoperative PELD score as the strongest predictor of early Kasai portoenterostomy failure requiring liver transplant within the first year. Patients with early procedure failure showed significantly worse survival outcomes (47% at 1 year) compared to those with successful procedures (100% at 1 year), suggesting primary liver transplantation may be warranted in high-risk cases.