Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults
Background : Some young adults have a long survival period with native liver after Kasai portoenterostomy (KPE) for biliary atresia (BA). However, a considerable proportion of these patients require liver transplantation (LT). This study aimed to analyze the indications and outcomes of LT in young a...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2021-09-01
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| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.21.0018 |
| _version_ | 1797370114037776384 |
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| author | Jung-Man Namgoong Shin Hwang Chul-Soo Ahn Deok-Bog Moon Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Young-In Yoon Kyung Mo Kim Sung-Gyu Lee |
| author_facet | Jung-Man Namgoong Shin Hwang Chul-Soo Ahn Deok-Bog Moon Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Young-In Yoon Kyung Mo Kim Sung-Gyu Lee |
| author_sort | Jung-Man Namgoong |
| collection | DOAJ |
| description | Background : Some young adults have a long survival period with native liver after Kasai portoenterostomy (KPE) for biliary atresia (BA). However, a considerable proportion of these patients require liver transplantation (LT). This study aimed to analyze the indications and outcomes of LT in young adults after a long survival period with native liver after KPE. Methods : We selected seven patients who were 18 years or older at the time of LT out of 116 BA patients who underwent primary LT from 2008 to 2019 at Asan Medical Center. Results : The mean ages at KPE and LT were 2.1±0.9 months and 22.0±5.1 years, respectively. Mean serum total bilirubin level and model for end-stage liver disease score at LT were 7.91±7.22 mg/dL and 15.3±6.0, respectively. The main reasons for LT were liver cirrhosis with portal hypertension-associated complications in five patients and intractable cholangitis in two patients. There were five cases of living donor LT and two cases of deceased donor LT. All the seven patients are currently alive during the mean follow-up period of 74.7±40.9 months. One patient suffered from outflow graft vein obstruction requiring endovascular stenting. Another patient showed core antibody-positivity-induced de novo hepatitis B virus infection, which was well managed with antiviral therapy. Conclusions: Young adult patients with BA are a unique group of patients requiring specialist care regarding transition from pediatric to adult services. The outcomes of LT in young adult BA patients were excellent. Therefore, LT should be considered in patients showing serious BA-associated complications. |
| first_indexed | 2024-03-08T17:56:47Z |
| format | Article |
| id | doaj.art-eec9cb5860584676bb1bf697124bbc4f |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T17:56:47Z |
| publishDate | 2021-09-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-eec9cb5860584676bb1bf697124bbc4f2024-01-02T04:34:13ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902021-09-0135317718210.4285/kjt.21.0018kjt.21.0018Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adultsJung-Man Namgoong0Shin Hwang1Chul-Soo Ahn2Deok-Bog Moon3Tae-Yong Ha4Gi-Won Song5Dong-Hwan Jung6Gil-Chun Park7Young-In Yoon8Kyung Mo Kim9Sung-Gyu Lee10Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground : Some young adults have a long survival period with native liver after Kasai portoenterostomy (KPE) for biliary atresia (BA). However, a considerable proportion of these patients require liver transplantation (LT). This study aimed to analyze the indications and outcomes of LT in young adults after a long survival period with native liver after KPE. Methods : We selected seven patients who were 18 years or older at the time of LT out of 116 BA patients who underwent primary LT from 2008 to 2019 at Asan Medical Center. Results : The mean ages at KPE and LT were 2.1±0.9 months and 22.0±5.1 years, respectively. Mean serum total bilirubin level and model for end-stage liver disease score at LT were 7.91±7.22 mg/dL and 15.3±6.0, respectively. The main reasons for LT were liver cirrhosis with portal hypertension-associated complications in five patients and intractable cholangitis in two patients. There were five cases of living donor LT and two cases of deceased donor LT. All the seven patients are currently alive during the mean follow-up period of 74.7±40.9 months. One patient suffered from outflow graft vein obstruction requiring endovascular stenting. Another patient showed core antibody-positivity-induced de novo hepatitis B virus infection, which was well managed with antiviral therapy. Conclusions: Young adult patients with BA are a unique group of patients requiring specialist care regarding transition from pediatric to adult services. The outcomes of LT in young adult BA patients were excellent. Therefore, LT should be considered in patients showing serious BA-associated complications.http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.21.0018portal hypertension; cholangitis; liver cirrhosis; portoenterostomy; adolescence |
| spellingShingle | Jung-Man Namgoong Shin Hwang Chul-Soo Ahn Deok-Bog Moon Tae-Yong Ha Gi-Won Song Dong-Hwan Jung Gil-Chun Park Young-In Yoon Kyung Mo Kim Sung-Gyu Lee Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults Korean Journal of Transplantation portal hypertension; cholangitis; liver cirrhosis; portoenterostomy; adolescence |
| title | Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults |
| title_full | Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults |
| title_fullStr | Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults |
| title_full_unstemmed | Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults |
| title_short | Indications and outcomes of liver transplantation for post-Kasai biliary atresia in young adults |
| title_sort | indications and outcomes of liver transplantation for post kasai biliary atresia in young adults |
| topic | portal hypertension; cholangitis; liver cirrhosis; portoenterostomy; adolescence |
| url | http://journaleditor.inforang.com/journal/view.html?doi=10.4285/kjt.21.0018 |
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