Article Text

Download PDFPDF

How to evaluate diagnosis and management of biliary atresia in the era of liver Transplantation in China
  1. Jianghua Zhan1,
  2. Yajun Chen2 and
  3. Kenneth K Y Wong3
  1. 1 Department of Pediatric Surgery, Tianjin Children’s Hospital, Tianjin, China
  2. 2 Department of Pediatric Surgery, Beijing Children’s Hospital, Beijing, China
  3. 3 Department of Pediatric Surgery, Queen Mary Hospital, Hong Kong, China
  1. Correspondence to Jianghua Zhan; zhanjianghuatj{at}


Background Biliary atresia (BA) is one of the most challenging hepatobiliary diseases in children. Notwithstanding the reasonable outcome of liver transplantation (LT), portoenteral anastomosis (Kasai operation) is still the first choice of treatment for patients with BA. How to improve the survival rate of the patients with BA in the era of LT is a new challenge.

Data sources Based on recent original publications and the experience with the BA in China, we review many factors that influence BA survival situation, including early diagnosis and screen plan, defects of early treatment, Kasai operation, and LT and indicate present questions about BA diagnosis and treatment in China.

Results BA diagnosis may also be delayed due to insufficient understanding of BA and lack of jaundice monitoring methods at different levels of the hospitals in China. Further education of the physicians at smaller city hospitals about BA, neonatal jaundice and cholestasis would be helpful in improving early diagnosis of BA. Early surgical intervention is still the only guarantee to improve the survival rate of BA with native liver.

Conclusions In the era of LT, especially in China, Kasai operation can provide waiting time for living donor LT and improve the success rate of LT and minimize the rapid deterioration of liver function of the children with BA and decrease the mortality in patients with BA.

  • biliary atresia
  • kasai
  • liver transplantation
  • survival situation
  • China

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors JZ proposed the project and wrote the paper, YC and Wong KKY helped to edit the manuscript.

  • Funding This study was supported by National Natural Fund: 81570471. Tianjin Institutes of Health grants: 14KG129.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Informed consent from study participants were waived because the data analyses were from spread sheets.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.