biostudies-literatureUnknown11Kwon Y<h4>Objective</h4>Biliary atresia (BA) patients develop chronic liver disease after the Kasai operation and are eventually indicated for liver transplantation (LT). The purposes of this study were to analyze long-term outcomes after LT and risk factors that affect complications to reduce graft failure.<h4>Study design</h4>Overall, 145 pediatric patients who underwent LT between June 1996 and June 2020 after a diagnosis of BA were included. We performed a retrospective analysis of medical records and evaluated patient and graft survival, cumulative incidence of complications, risk factors, and the results of policy changes.<h4>Results</h4>Patient and graft survival rates in over 20 years were 95.8% and 91.0%, respectively. Post-transplantation lymphoproliferative disease was frequently observed in the early period of immunosuppression within the first 1-2 years after LT. The incidence of cholangitis and rejection steadily increased over time. Weight-to-portal vein size was evaluated as a risk factor for cholangitis and bile duct strictures (OR = 12.82, <i>p</i> = 0.006 and OR = 16.54, <i>p</i> = 0.015, respectively). When evaluated using 2013 as a reference point, the split graft indication was expanded and the group that received LT after 2013 had a significantly lower survival over time compared with that of the group that received LT before 2013 (<i>p</i> = 0.006).<h4>Conclusion</h4>This study revealed time differences in prevalence of complications. The evaluation of weight-to-duct or vessel size is a more important factor in considering complications than the graft-to-recipient weight ratio. Survival outcomes may have been altered by a policy change that affects the donor type ratio in transplantation.Frontiers in pediatrics1242009https://www.ebi.ac.uk/biostudies/studies/S-EPMC10940458biostudies-literatureLong-term outcomes of liver transplantation for biliary atresia and results of policy changes: over 20 years of follow-up experience.PMC10940458Choe YHLee SYang JKwon YKim ESKim MJAhn YJfalseLong-term outcomes of liver transplantation for biliary atresia and results of policy changes: over 20 years of follow-up experience.<h4>Objective</h4>Biliary atresia (BA) patients develop chronic liver disease after the Kasai operation and are eventually indicated for liver transplantation (LT). The purposes of this study were to analyze long-term outcomes after LT and risk factors that affect complications to reduce graft failure.<h4>Study design</h4>Overall, 145 pediatric patients who underwent LT between June 1996 and June 2020 after a diagnosis of BA were included. We performed a retrospective analysis of medical records and evaluated patient and graft survival, cumulative incidence of complications, risk factors, and the results of policy changes.<h4>Results</h4>Patient and graft survival rates in over 20 years were 95.8% and 91.0%, respectively. Post-transplantation lymphoproliferative disease was frequently observed in the early period of immunosuppression within the first 1-2 years after LT. The incidence of cholangitis and rejection steadily increased over time. Weight-to-portal vein size was evaluated as a risk factor for cholangitis and bile duct strictures (OR = 12.82, <i>p</i> = 0.006 and OR = 16.54, <i>p</i> = 0.015, respectively). When evaluated using 2013 as a reference point, the split graft indication was expanded and the group that received LT after 2013 had a significantly lower survival over time compared with that of the group that received LT before 2013 (<i>p</i> = 0.006).<h4>Conclusion</h4>This study revealed time differences in prevalence of complications. The evaluation of weight-to-duct or vessel size is a more important factor in considering complications than the graft-to-recipient weight ratio. Survival outcomes may have been altered by a policy change that affects the donor type ratio in transplantation.2023-01-01T00:00:00Z20232026-06-26T03:09:41.814Z2026-06-26T03:07:58.993ZS-EPMC109404583849583810.3389/fped.2023.1242009