Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center.

Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center. Research Abstract Details 

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Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center. Abstract Text:

Tatsuya Okamoto,Akiko Yokoi,Shinya Okamoto,Shigeru Takamizawa,Shiiki Satoh,Toshihiro Muraji,Shinji Uemoto,Eiji Nishijima,

BACKGROUND/PURPOSE: Although living-related liver transplantation (LRLT) is effective for patients with biliary atresia (BA) after a failed Kasai operation, the pretransplant factors affecting post-LRLT mortality and the optimal timing of the procedure remain unclear. METHOD: A retrospective review of 27 patients with BA after a failed Kasai operation (median age, 22 months; range, 6-237 months) who received LRLT from 1994 to 2005 was done. The clinical characteristics at the time of the pre-LRLT assessment of those who did and did not survive were compared. A simple regression analysis and receiver operating characteristic analysis were done to correlate the clinical data. RESULTS: Among the 27 patients, 4 patients died within 1 year post-LRLT. The significant factors affecting posttransplant death were hepatopulmonary syndrome (HPS), age at LRLT, and graft-to-recipient weight ratio. The arterial blood gas analysis of HPS patients showed that there was a significant negative correlation between the SaO(2) value on room air and the intrapulmonary shunt ratio. The receiver operating characteristic analysis of age at LRLT showed that the optimal cutoff point was 103 months of age. CONCLUSION: Older children with HPS or a lower graft-to-recipient weight ratio are not ideal candidates for LRLT. The correlation between the shunt ratio and SaO(2) suggests that HPS could be detected early using pulse oximetry.

Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center. Publishing Authors By Initials

T Okamoto,A Yokoi,S Okamoto,S Takamizawa,S Satoh,T Muraji,S Uemoto,E Nishijima,

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Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of pediatric surgery

VOLUME: 43

Page Numbers: 489-94

Journal Abbreviation: J. Pediatr. Surg.

ISSN: 1531-5037

DAY: 24

MONTH: Mar

YEAR: 2008

Pretransplant risk factors and optimal timing for living-related liver transplantation in biliary atresia: experience of one Japanese children's hospital and transplantation center. Information

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LANGUAGE: eng

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AFFILIATION: Department of Pediatric Surgery, Kobe Children's Hospital, Kobe 654-0081, Japan. okamoto_kch@hp.pref.hyogo.jp

Country: United States

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MEDLINETA: J Pediatr Surg

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