Operation Procedure: Living Donor Liver Transplantation for Biliary Atresia

Biliary atresia is the most common indication for liver transplantation in pediatric population. This chapter provide surgical technique and the comprehensive factors that might influence the outcomes of patients with biliaryt atresia who undergo living donor liver transplantation in the largest pediatric organ transplantation center in Japan. Surgical technique involves the donor surgery, the recipient vascular and biliary reconstructions including surgical tips. The donor body mass index, ABO incompatibility, graft type, recipient age, center experience and transplant era were found to be significant predictors of the overall graft survival. Adolescent age (12 to <18 years) was associated with a significantly worse long-term graft survival rate than younger or older ages. We conclude that living donor live rtransplantation for biliary atresia is a safe and effective treatment modality that does not compromise living donors. The optimum timing for living donor liver transplantation is crucial for a successful outcome, and early referral to transplantation center can improve the short-term outcomes of liver transplantation for biliary atresia. Further investigation of the major cause of death in liver transplanted recipients with biliary atresia in the long-term is essential, especially among adolescents.