Evaluation of liver transplant scoring system in predicting the survival rate of biliary atresia patients after liver transplant

Abstract

Introduction: Biliary atresia (BA) is a degenerative, idiopathic, and progressive fibrotic disease of the intra and extra hepatic bile ducts that manifests with biliary obstruction exclusively in infancy. Although its general incidence is low, it is the most common cause of neonatal jaundice that surgery has indication for it and it is the most common indication for liver transplant in infants. The aim of present study is to use a liver scoring system for predicting the rate of survival of BA patients after liver transplant.

Methods: All patients with confirmed BA diagnosis underwent liver transplant at Shiraz Transplant Center from 2010 to 2019 were included in the study. Demographic and paraclinical data were extracted from patients' medical records. Liver Transplant Score (LTS) was calculated based on the latest paraclinical data before transplant.

Results of 120 children with BA underwent liver transplant were examined in this study. The mean LTS in patients was 7.64 ± 1.75. 61.7% of patients were in the group of lower than 8 and 38.3% of patients were in the group of higher than 8. In total, 37 subjects (30.8%) died and 83 (69.2%) survived. There was a statistically significant relationship between good and poor prognosis based on LTS classification and death of patients.

Conclusion: The results of our study suggest that the LTS system in BA patients can determine the prognosis of patient mortality. Adding the variable of age to this scoring system can help increase its predictive power.