Progressive Factors Of Liver Cirrhosis And Opportunity Of Liver Transplatation In Congenital Bliiary Atresia

Objective:To analyze factors that may influence the progression of liver cirrhosis and opportunity of liver transplantation.Methods:A retrospective review of 24 cases of liver transplantation（LT）diagnosed as BA from February 2012 to December2018 to explorer the impact on course of disease or the age of liver transplantation caused by gender,therapy method,preoperative total bilirubin（TB）,preoperative direct bilirubin（DB,and delta bilirubin included）,preoperative DB/TB,preoperative gamma glutamyl transpeptidase（GGT）.Results:Preoperative DB,preoperative TB,preoperative DB/TB has no impact on course of disease and the age of LT with a P value>0.05while preoperative GGT has positive correlation with them with a P value<0.05.Besides,in 95.8%（23/24）cases of this research,DB/TB is equal or greater than 0.7.And 95.24%（20/21）of these cases in stage IV,DB/TB is equal or greater than 0.7.In turn,when DB/TB is equal or greater than 0.7,87.9%（20/23）cases is in stage IV.Conclusion:Gender,therapy method,age of 1^st surgery,course of disease cannot change the outcome of liver cirrhosis in BA.For liver cirrhosis is difficult to diagnose by auxiliary examination in its early stages except liver biopsy at present,we can not search for the connection between factors above and progression of liver cirrhosis.the age of LT is not so absolute in our hospital and ranges form 153 to 508 days.When preoperative DB/TB is equal or greater than 0.7 persistently which highly suggests liver cirrhosis,no matter if the patient has underwent a Kasai portoenterostomy（KP）,the patient may need a liver transplantation operation.And a better clinical applicability exists to test DB/TB than liver biopsy.Therefore,considering from a single factor,DB/TB has a strong clinical application value in determining the timing of liver transplantation in children with congenital biliary atresia.