caa a22 4500 465772765 CHVBK 20180323111933.0 cr unu---uuuuu 170327e19900201xx s 000 0 eng 10.1007/BF00178224 doi (NATIONALLICENCE)springer-10.1007/BF00178224 Biliary atresia: perspective on transplantation [Elektronische Daten] [Roberta Hall, Frederick Karrer] In North America, long-term, jaundice-free survival following Kasai's operation for biliary atresia is 25%-35%; thus, the majority of patients require liver transplantation for salvage. The timing of organ replacement is crucial. Patients without bile drainage because of either surgical election or operative failure should be referred immediately. Patients with ongoing but inadequate biliary drainage should be referred at a time that coincides with a plateau of the growth curve or if cholangitis is recalcitrant. Portal hypertension itself is not an indication for transplantation irrespective of its manifestations. Ascites, however, when primarily due to hypoalbuminemia, is a solid indication for transplantation. Other tests of liver function are generally unreliable. Factors found to be unimportant or of questionable adverse impact on transplant outcome include previous operation, coexisting infection limited to the liver, nonpatent portal vein, and/or abnormal liver function tests. The only factor that was found to significantly influence outcome was patient size and age. Thus, bile drainage after Kasai portoenterostomy, by permitting growth, improves the chances for a favorable outcome. Transplant 1-year survival is from 60% to 88%. Liver replacement is not without complications, namely technical errors, infection, and rejection. Nonetheless, in a majority of cases hepatic transplantation provides the only opportunity for high-quality long-term survival. Springer-Verlag, 1990 Liver transplantation nationallicence Biliary atresia nationallicence Hall Roberta Department of Surgery C 314, University of Colorado School of Medicine, 4200 East Ninth Avenue, 80262, Denver, CO, USA aut Karrer Frederick Department of Surgery C 314, University of Colorado School of Medicine, 4200 East Ninth Avenue, 80262, Denver, CO, USA aut Pediatric Surgery International Springer-Verlag 5/2(1990-02-01), 94-99 0179-0358 5:2<94 1990 5 383 https://doi.org/10.1007/BF00178224 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00178224 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hall Roberta Department of Surgery C 314, University of Colorado School of Medicine, 4200 East Ninth Avenue, 80262, Denver, CO, USA aut NATIONALLICENCE 700 1- Karrer Frederick Department of Surgery C 314, University of Colorado School of Medicine, 4200 East Ninth Avenue, 80262, Denver, CO, USA aut NATIONALLICENCE 773 0- Pediatric Surgery International Springer-Verlag 5/2(1990-02-01), 94-99 0179-0358 5:2<94 1990 5 383 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer