{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:12:49Z","timestamp":1777695169107,"version":"3.51.4"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Age at Kasai portoenterostomy (KPE) has been identified as a predictive factor for native-liver survival in patients with biliary atresia (BA). Outcomes of pediatric liver transplantation (LT) have improved over recent years. It has been proposed to consider primary LT as a treatment option for late-presenting BA infants instead of attempting KPE. We present our experience with patients older than 90 days undergoing KPE.<\/jats:p><jats:p>\n          Materials and Methods\u2003A retrospective chart review of patients with BA undergoing KPE at our institution between January 2010 and December 2020 was performed. Patients 90 days and older at the time of surgery were included. Patients' characteristics, perioperative data, and follow-up results were collected. Eleven patients matched the inclusion criteria. Mean age at KPE was 108 days (range: 90\u2013133 days).<\/jats:p><jats:p>\n          Results\u2003Postoperative jaundice clearance (bilirubin\u2009&lt;\u20092\u2009mg\/dL) at 2-year follow-up was achieved in three patients (27%). Eight patients (73%) received a liver transplant at a mean of 626 days (range: 57\u20132,109 days) after KPE. Four patients (36%) were transplanted within 12 months post-KPE. Two patients died 237 and 139 days after KPE due to disease-related complications. One patient is still alive with his native liver, currently 10 years old.<\/jats:p><jats:p>\n          Conclusion\u2003Even when performed at an advanced age, KPE can help prolong native-liver survival in BA patients and offers an important bridge to transplant. In our opinion, it continues to represent a viable primary treatment option for late-presenting infants with BA.<\/jats:p>","DOI":"10.1055\/s-0041-1740556","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T01:28:13Z","timestamp":1639704493000},"page":"080-084","source":"Crossref","is-referenced-by-count":11,"title":["Kasai Procedure in Patients Older Than 90 Days: Worth a Cut"],"prefix":"10.1055","volume":"32","author":[{"given":"Marie","family":"Uecker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim F.","family":"Kuebler","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagoud","family":"Schukfeh","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva-Doreen","family":"Pfister","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Baumann","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omid","family":"Madadi-Sanjani","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hannover Medical School, Hannover, 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