Primary liver transplantation vs transplant after Kasai portoenterostomy in children with biliary atresia: A retrospective Brazilian single-center cohort

Table 1 Pre and intra-operative variables in biliary atresia recipients who underwent liver transplantation with and without previous portoenterostomy, n (%)

Parameter	No-PE, n = 23	PE, n = 19	P value
Sex, female	13 (56.5)	12 (63.2)	0.75
Age at LT, months	8 (6-10)	12 (7-23)	0.02
Weight at LT, kg, median (IQR)	6.5 (5.7-7.4)	7 (6.4-13.5)	0.15
PELD/MELD, mean ± SD	21.4 ± 9.5	13.2 ± 8.9	0.01
Living donor	19 (82.6)	16 (84.2)	1
Deceased donor	4 (17.4)	3 (15.8)
GRWR, mean ± SD	4.0 ± 1.3	3.7 ± 1.7	0.4
RCBT in mL/kg, mean ± SD	2.4 ± 0.9	1.6 ± 1.3	0.15
CIT in min, median (IQR)	81 (61-140)	105 (73-189)	0.24
WIT in min, mean ± SD	39.4 ± 12.5	33.8 ± 8.4	0.11
Time to extubate in d, median (IQR)	1 (0-2)	0 (0-1)	0.55
ICU stay in d, median (IQR)	12 (6-17)	8 (5-14)	0.4
Hospital stay in d, median (IQR)	21 (16-37)	23 (15-30)	0.25

Data are n (%). CIT: Cold ischemia time; GRWR: Graft-to-recipient-weight-ratio; ICU: Intensive care unit; IQR: Interquartile range; LT: Liver transplant; PE: Portoenterostomy; RCBT: Red cell blood transfusion; SD: Standard deviation; WIT: Warm ischemia time.

Table 2 Outcomes in biliary atresia recipients who underwent liver transplantation with and without previous portoenterostomy

Parameter	No-PE, n = 23	PE, n = 19	P value
HAT	2 (8.7)	4 (21.1)	0.38
PVT	9 (39.1)	2 (10.5)	0.07
PVS	4 (17.4)	4 (21.1)	1
Biliary fistula	9 (39.1)	6 (31.6)	0.75
Biliary stricture	5 (21.7)	8 (42.1)	0.19
Reoperation	7 (30.4)	2 (10.5)	0.14
Acute rejection	5 (21.7)	3 (15.8)	0.7
Chronic rejection	2 (8.7)	0	0.49
EBV infection	14 (60.9)	9 (47.4)	0.5
CMV infection	19 (82.6)	13 (68.4)	0.46

Data are n (%). CMV: Cytomegalovirus; EBV: Epstein Barr virus; HAT: Hepatic artery thrombosis; LT: Liver transplant; PE: Portoenterostomy; PVS: Portal vein stenosis; PVT: Portal vein thrombosis.

Table 3 Pre and intra-operative variables in biliary atresia recipients who underwent liver transplantation who developed portal vein thrombosis comparing with those who did not develop portal vein thrombosis

Parameter	No-PVT, n = 31	PVT, n = 11	P value
Age at LT, months, median (IQR)	10 (6-15)	8 (5-8)	0.06
Weight at LT, kg, median (IQR)	7 (6.2-10)	6.4 (5.7-7.3)	0.2
PE	17 (54.8)	2 (18.2)	0.07
PELD/MELD, mean ± SD	16.1 ± 10.3	22 ± 8	0.12
Living donor	26 (83.9)	9 (81.8)	1
Deceased donor	5 (16.1)	2 (18.2)	1
Portal vein graft	5 (16.1)	5 (45.5)	0.09
GRWR, mean ± SD	3.75 ± 1.56	4.38 ± 1.2	0.08
RCBT in mL/kg, mean + SD	1.8 ± 1.3	2.5 ± 0.9	0.14
CIT in min, median (IQR)	95 (66-163.5)	88 (68-127)	0.8
WIT in min, mean ± SD	36.1 ± 9.9	39 ± 14.1	0.7

Data are n (%). BA: Biliary atresia; CIT: Cold ischemia time; GRWR: Graft-to-recipient-weight-ratio; LT: Liver transplant; PE: Portoenterostomy; PVT: Portal vein thrombosis; RCBT: Red cell blood transfusion; SD: Standard deviation; WIT: Warm ischemia time.

Table 4 Logistic regression analysis for portal vein thrombosis

Parameter	OR	95%CI	P value
PE	0.35	0.05-2.27	0.27
GRWR	1.03	0.52-2.02	0.92
Age at LT	0.84	0.63-1.12	0.24
Portal vein graft	2.87	0.54-15.1	0.21

CI: Confidence interval; GRWR: Graft-to-recipient-weight-ratio; LT: Liver transplant; OR: Odds ratio; PE: Portoenterostomy; PVT: Portal vein thrombosis.