Biliary atresia is the most common indication for
liver transplantation (OLT) in children. We present our experience with OLT as a treatment for
end-stage liver disease in children with
biliary atresia. We performed a retrospective review of 20
biliary atresia patients (11 male, 9 female patients; mean age, 21.4 months; range, 6 to 84 months) who had undergone OLT. Mean preoperative weight and height were 10.1 +/- 5.8 kg and 72.5 cm, respectively. Thirteen recipients were younger than 1 year of age, and 15 weighed less than 10 kg at the time of OLT. Fourteen recipients had undergone a Kasai operation prior to the OLT. The mean serum total
bilirubin level was 22.56 mg/dL before OLT. Eighteen left lateral segment grafts and two whole grafts were transplanted. The mean recipient
operative time was 9.25 hours. The mean recipient intraoperative blood loss was 1.81 U. Two hepatic arterial
thromboses and one biliary leak occurred soon after surgery. Portal vein
stenoses developed in two recipients
at 10 and 12 months after OLT; both were treated with balloon dilatation. Two biliary
stenoses, which occurred
at 10 months and 3.5 years after surgery, were treated with balloon dilatation. Two recipients died at 2 and 12 days after OLT because of
respiratory distress syndrome and
sepsis, respectively. The remaining 18 (90%) recipients are alive with good graft function. The overall rejection rate was 31.25%. OLT is an effective treatment for children with
biliary atresia and a failed
Kasai procedure. Living related liver grafts represented an excellent organ supply for these patients.