Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.88734
Peer-review started: October 17, 2023
First decision: November 2, 2023
Revised: November 14, 2023
Accepted: December 18, 2023
Article in press: December 18, 2023
Published online: March 18, 2024
Biliary atresia (BA) is the most common indication for pediatric liver trans
To investigate the effect of prior portoenterostomy in infants un
This was a retrospective cohort study of 42 pediatric patients with BA who underwent primary liver transplantation from 2013 to 2023 at a single tertiary center in Brazil. Patients with BA were divided into two groups: Those under
Forty-two patients were included in the study (25 [60%] girls), 23 undergoing liver transplantation without prior portoenterostomy, and 19 undergoing liver transplantation with prior portoenterostomy. Patients with prior portoenterostomy were older (12 vs 8 months; P = 0.02) at the time of liver transplantation and had lower Pediatric End-Stage Liver Disease scores (13.2 vs 21.4; P = 0.01). The majority of the patients (35/42, 83%) underwent living-donor liver transplantation. The group of patients without prior portoenterostomy appeared to have a higher incidence of portal vein thrombosis (39 vs 11%), but this result did not reach statistical significance. Prior portoenterostomy was not a protective factor against portal vein thrombosis in the multivariable analysis after adjusting for age at liver transplantation, graft-to-recipient weight ratio, and use of vascular grafts. Finally, the groups did not significantly differ in terms of post-transplant survival.
In our study, prior portoenterostomy did not significantly affect the outcomes of liver transplantation.
Core Tip: Children with biliary atresia comprise the majority of patients undergoing liver transplantation worldwide. Timely portoenterostomy can postpone or even remove the need for liver transplantation. Current data are not conclusive regarding whether performing a portoenterostomy negatively affects the transplantation procedure. In this study, we compared the outcomes of liver transplantation in patients with biliary atresia with or without prior portoenterostomy in a single center. Our results indicate that it does not affect the outcomes.