Liver transplantation among children with biliary atresia: Retrospective study

Title : Liver transplantation among children with biliary atresia: Retrospective study

Abstract:

Introduction: The most common bile duct disease in infants is biliary atresia (BA), which typically requires prompt surgical treatment for the best results, mostly pediatric liver transplantation. Globally, BA has an approximate frequency of 5 to 10 per 100,000 births. The study aims to retrospectively review outcomes of pediatric liver living donor transplantation for biliary atresia in Kazakhstan.

Materials and methods: The retrospective study was carried out at the National Research Surgery Center named after A.N.Syzganov, Almaty (NRSC). A total of children who were liver transplanted were 50 children delivered in Kazakhstan between 2016 and 2024.

Results: During 2016-2024, 26 females (52.0%) and 24 males (48.0%) were admitted to the hospital due to biliary atresia at a mean age (months) of M=10.5 (CI 95%: 7.00-8.75), SD=13.1, range 3-84. The average weight was 7.71±2.82, height - 67.9 ±12.3. LT is supported by the government, covering the whole period of hospitalization. According to the analysis of LT data, inpatient bed-day was 53.0, SD=27.2. Out of 50 patients with biliary atresia, 38 (76%) cases were successful, and 12 (24.0%) children died. Deaths were assessed by month M=0.25 (CI 95%:0-0.250) SD=0.452. The Gehan-Breslow-Wilcoxon test was used to compare group survival by gender because deaths occur early in follow-up, chi-square=0.0324, p=0.857. 

Conclusion: The first experience of fully covered pediatric liver living donor transplantation for biliary atresia in Kazakhstan was successful in 76% of cases. It is important to develop a National program on the implementation of the Stool Color Card and getting tested serum total and direct or conjugated bilirubin in all infants with persistent jaundice for more than two to three weeks for early liver transplantation/Kasai portoenterostomy.

Keywords: Biliary Atresia; Infant; Child; Liver Transplantation; Hepatic Portoenterostomy; Postoperative Complications; Treatment Outcome

Biography:

Dr. Nazira Yerimova is pediatric hepatologist in the Department of Pediatric Surgery at National Scientific Center of Surgery n.a А.N. Syzganov, Kazakhstan. She holds an PhD and has over 15 years of clinical and academic experience in pediatric hepatology. With more than 15 years of work in pediatrics and pediatric hepatology, her main research interests include biliary atresia, pediatric liver transplantation, and rare hepatobiliary disorders in children. She has published in peer-reviewed journals and presented at international conferences in France, New Zealand, and India.