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Kasai procedure improves nutritional status and decreases transplantation-associated complications

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Abstract

Background

The aim of this study was to retrospectively investigate whether Kasai Procedure (KP) improves nutritional status and whether KP decreases liver transplantation (LT)-associated complications in children with biliary atresia (BA).

Methods

From March 1st 2014 to February 28th 2015, 103 patients underwent LT and the other 17 without prior KP died during the waiting period. In 103 patients undergoing LT, 58 patients received KP previously (Group A), and 45 only underwent primary LT (Group B). The nutritional status, liver function and LT-related short-term complications were analyzed.

Results

Compared to Group B, patients in Group A had significantly increased time interval when undergoing LT (p < 0.05). Persistently, the bodyweight, albumin and hemoglobin in Group A were significantly increased compared to Group B (all, p < 0.0001). The bilirubin, ALT/AST and PELD score in Group A were all decreased compared to Group B (p < 0.05) prior to LT. The incidences of post-LT severe infection and hypoalbuminemia in Group A were significantly lower than those of Group B (p < 0.05).

Conclusions

KP improves the nutritional status, preserves liver function for patients who finally undergo LT, and decreases the incidence post-LT severe infection and hypoalbuminemia. Mental health can be improved in parents whose children underwent previous KP.

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Funding

This work is supported by National Natural Science Foundation of China (Grant Nos. 81401240, 81571478) and Tianjin Health Bureau key Projects (14KG129).

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Jixin Yang & Jiexiong Feng

  2. Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China

    Wei Gao

  3. Department of Pediatric Surgery, Tianjin Children’s Hospital, Tianjin, China

    Jianghua Zhan

Authors
  1. Jixin Yang
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  2. Wei Gao
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  3. Jianghua Zhan
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  4. Jiexiong Feng
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Contributions

JY: Concept/design, Data collection, Data analysis/interpretation, Drafting article Statistics. WG: Data collection, Data analysis/interpretation, Approval of article. JZ: Data collection, Data analysis/interpretation, Approval of article. JF: Concept/design, Critical revision of article, Approval of article, Statistics.

Corresponding author

Correspondence to Jiexiong Feng.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

Written informed consent was obtained from the guardians of the patients included in this study. The Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology approved the protocol of the study (Permit Number 2010-HP0761, Wuhan, China). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yang, J., Gao, W., Zhan, J. et al. Kasai procedure improves nutritional status and decreases transplantation-associated complications. Pediatr Surg Int 34, 387–393 (2018). https://doi.org/10.1007/s00383-018-4228-2

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