What Makes A "Successful" Kasai Portoenterostomy "Unsuccessful"?

This study of 135 biliary atresia patients found that 22% who initially achieved jaundice clearance after Kasai portoenterostomy still required liver transplantation, primarily due to cholangitis (90%) and portal hypertension (50%). Predictive markers at 3 months including elevated APRi, bilirubin, INR, and ultrasound-detected ascites showed strong correlation with subsequent transplant need.