Abstract
Two anicteric children were transplanted for hepatic decompensation 5 and 7 years after an initial “successful” Kasai portoenterostomy. Examination of the hepatectomy specimens showed two distinct zones: a central zone of apparently normal parenchyma with draining ductules surrounded by a peripheral zone of fibrotic tissue with no ductules. This is in contrast with the completely fibrotic explanted livers from children who are persistently jaundiced after an unsuccessful Kasai procedure. It is possible that the peripheral fibrotic tissue might have prevented the normal growth of the draining central segment, leading to hepatic decompensation at a later age. It may also contribute to the development of the portal hypertension seen so often in these patients. The earliest evidence of impending hepatic decompensation in these two cases was a steady decline in serum albumin level.
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Correspondence to: K. C. Tan
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Yeung, C.K., Rela, M., Heaton, N. et al. Liver transplantation after “successful” Kasai portoenterostomy: evidence that liver decompensation results from fibrotic encasement of central normal liver. Pediatr Surg Int 8, 303–305 (1993). https://doi.org/10.1007/BF00173350
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DOI: https://doi.org/10.1007/BF00173350