{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T18:28:06Z","timestamp":1790447286398,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T00:00:00Z","timestamp":1435276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T00:00:00Z","timestamp":1435276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:p>Biliary atresia (BA) is the main diagnosis leading to liver transplantation (LT) in children. When diagnosed early in life, a Kasai portoenterostomy (Kasai\u2010PE) can prevent or postpone LT. Instances of previous operations can result in difficulties during the LT. We hypothesized that a previous Kasai\u2010PE could affect LT outcomes. A retrospective cohort study of 347 BA patients submitted to LT between 1995 and 2013 at Hospital S\u00edrio\u2010Liban\u00eas and A. C. Camargo Cancer Center was conducted. Patients were divided into those with a previous Kasai portoenterostomy early failure (K\u2010EF), Kasai portoenterostomy late failure (K\u2010LF), and those with no Kasai portoenterostomy (No\u2010K). Primary outcomes were patient and graft survival. A total of 94 (27.1%) patients had a K\u2010EF, 115 (33.1%) had a K\u2010LF, and 138 (39.8%) had No\u2010K before LT. Children in the K\u2010LF group were older and had lower Pediatric End\u2010Stage Liver Disease (PELD) scores. Patients in both K\u2010EF and K\u2010LF groups had more post\u2010LT biliary complications. After Cox\u2010multivariate analysis adjusting for confounding factors to determine the influence of Kasai\u2010PE on patient and graft survival, the K\u2010LF group had an 84% less probability of dying and a 55% less chance to undergo retransplantation. The K\u2010LF group had a protective effect on posttransplant patient and graft survival. When properly performed, the Kasai procedure can postpone LT and positively affect outcomes. Having a K\u2010EF and having not performed a Kasai\u2010PE had the same effect in patient and graft survival; however, a previous Kasai\u2010PE can increase post\u2010LT complications as biliary complications and bowel perforations. <jats:italic toggle=\"yes\">Liver Transpl 21:922\u2010927, 2015<\/jats:italic>. \u00a9 2015 AASLD.<\/jats:p>","DOI":"10.1002\/lt.24132","type":"journal-article","created":{"date-parts":[[2015,4,2]],"date-time":"2015-04-02T22:07:49Z","timestamp":1428012469000},"page":"922-927","source":"Crossref","is-referenced-by-count":55,"title":["Impact of Kasai portoenterostomy on liver transplantation outcomes: A retrospective cohort study of 347 children with biliary atresia"],"prefix":"10.1097","volume":"21","author":[{"given":"Joao Seda","family":"Neto","sequence":"first","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fl\u00e1via H.","family":"Feier","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza","family":"Bierrenbach","sequence":"additional","affiliation":[{"name":"Teaching and Research Institute, Hospital Sirio\u2010Libanes,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana M.","family":"Toscano","sequence":"additional","affiliation":[{"name":"Department of Health,Instituto de Patologia Tropical e Sa\u00fade P\u00fablica, Universidade Federal de Goi\u00e1s,Goi\u00e1s,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo A.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helry L.","family":"Candido","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel R.","family":"Benavides","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilda","family":"Porta","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"},{"name":"Hepatology and Liver Transplantation,A. C. Camargo Cancer Center,S\u00e3o Paulo,S\u00e3o Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Chapchap","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation,Sao Paulo,Sao Paulo,Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2015,6,26]]},"reference":[{"key":"lt24132-bib-0001-20240115","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1750-1172-1-28","article-title":"Biliary atresia","volume":"1","year":"2006","journal-title":"Orphanet J Rare Dis"},{"key":"lt24132-bib-0002-20240115","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1001\/archsurg.1996.01430170039006","article-title":"Long\u2010term results with the Kasai operation for biliary atresia","volume":"131","year":"1996","journal-title":"Arch Surg"},{"key":"lt24132-bib-0003-20240115","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/S0140-6736(04)16045-5","article-title":"Seamless management of biliary atresia in England and Wales (1999\u20102002)","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"lt24132-bib-0004-20240115","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1016\/0016-5085(90)90489-N","article-title":"Long\u2010term outcome after surgery for biliary atresia. 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