Liver transplantation following the Kasai procedure in treatment of biliary atresia: A single institution analysis

Hideyuki Sasaki, Hiromu Tanaka, Motoshi Wada, Takuro Kazama, Kotaro Nishi, Megumi Nakamura, Hironori Kudo, Naoki Kawagishi, Masaki Nio

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10 Citations (Scopus)


Purpose: This study aimed to assess outcomes of liver transplantation (LTx) in patients with biliary atresia (BA). Methods: The Kasai procedure was performed for 358 patients at Tohoku University Hospital between January 1955 and December 2013; 64 (17.9 %) required LTx. These 64 patients were divided into 4 groups according to their age at the time of transplantation: Group 1, aged <2 years (n = 27); Group 2, aged 2-9 years (n = 16); Group 3, aged 10-19 years (n = 11); and Group 4, aged ≥20 years (n = 10). Clinical parameters were evaluated retrospectively. Results: Both living-donor (n = 57) and deceased-donor (n = 7) LTx were performed. Indications were irreversible jaundice (n = 53), intractable cholangitis (n = 3), hepatopulmonary syndrome (n = 6), portopulmonary hypertension (n = 1), and intestinal bleeding (n = 1). Jaundice occurred more frequently in Groups 1 and 2 than in Groups 3 and 4 (p = 0.031). Survival rates were 81.5, 100, 90.9, and 80 % in Groups 1, 2, 3, and 4, respectively. Conclusion: Although the overall LTx survival rate was satisfactory, some adult recipients experienced LTx-related difficulty. Close follow-up, meticulous assessment of physical and social conditions, presence of a multidisciplinary support system, and appropriate time course for LTx are all essential factors in the treatment of BA.

Original languageEnglish
Pages (from-to)871-875
Number of pages5
JournalPediatric Surgery International
Issue number9
Publication statusPublished - 2014 Sept


  • Biliary atresia
  • Donor
  • Liver transplantation
  • Long-term follow-up

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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