Abstract: Objective To explore the influencing factors of the survival time of autologous liver after Kasai procedure for biliary atresia(BA), and to find out the risk factors of early liver transplantation, so as to provide data of evidence-based medicine for BA treatment. Methods Data of 167 BA children underwent liver transplantation due to hepatic failure after Kasai procedure were retrospectively analyzed. According to the operation interval between Kasai procedure and liver transplantation, they were divided into G1 (≤6 months), G2 (＞6 months - 2 years) and G3 (>2 years) groups. Data of patient gender, patient age of Kasai procedure, jaundice clearance, cholangitis after Kasai procedure and liver function indexes before liver transplantation were compared between three groups. The χ2 test, variance analysis, Kruskal-Wallis H test and multiple logistic regression analysis were used to find out the influencing factors for the survival time of autologous liver, that is, the influencing factors of early liver transplantation. Results There were no significant differences in gender and age of Kasai procedure between the three groups. There was statistical difference in the clearance of jaundice between the three groups (P＜0.01), showing a gradually increase from G1 to G3. There was significant difference in the early cholangitis between the three groups (P＜0.05), which was lower in G3 group than that of G1 group. There was significant difference in the late cholangitis after surgery between the three groups (P＜0.01), which was higher in G2 group than that of G1 group. There was statistical difference in the incidence of frequent cholangitis between the three groups (P＜0.05), which was lower in G3 group than that of G2 group. Multiple logistic regression analysis showed that persistent jaundice was the risk factor for native liver survival after Kasai procedure. Conclusion Persistent jaundice and early cholangitis after Kasai procedure can reduce the native liver survival time, which is related to the early liver transplantation. Persistent jaundice is a risk factor for early liver transplantation after Kasai procedure.

Key words: biliary atresia, liver transplantation, risk factors, Kasai procedure