Bilirubin Levels at 1st and 3rd Postoperative Months are Significant in Determining the Success of the Kasai Portoenterostomy

Aim: The aim of this retrospective study was to determine the indicators of survival with native liver (NLS) of patients operated for biliary atresia (BA). Materials and Methods: This review included 53 BA patients in a 13-year period. There were two groups: (1) NLS and (2) necessitating transplantation. Age at operation, and bilirubin levels on the 7th day, 1st and 3rd months postoperatively were recorded. Mann-Whitney U and logistic regression analysis were used for statistical analysis for NLS and liver transplantation (LTx). Results: Kasai portoenterostomy (KPE) was performed on 38 patients, and 15 were directed to LTx due to cirrhotic liver at presentation. Twenty-three of 38 patients with KPE survived with native liver, and 15/38 patients required LTx during follow-up. Mean age at portoenterostomy for NLS and necessitating LTx was 54.43 +/- 24.64 and 68.33 +/- 24.35 days respectively (p>0.05). The 1st and 3rd month bilirubin levels were lower in the NLS group (p<0.01). The 1St month and 3rd month bilirubin levels after KP were significant predictors for survival with NLS. A cut-off value of 5.7 mg/dL bilirubin level at the 1st month predicted the necessity of transplantation after KPE with a sensitivity of 83.3% and specificity of 78.9%. Conclusion: Bilirubin levels of the 1st and 3rd months are reliable predictors for the success of portoenterostomy.