Portal venous velocity in the follow-up of patients with biliary atresia after Kasai portoenterostomy

Background/Purpose: Liver transplantation is the only therapeutic option for biliary atresia (BA) patients with failed Kasai portoenterostomy (PE). The indication for and timing of liver transplantation in these patients are important management issues. The aims of this study are to evaluate the relationship between portal venous velocity (PVV) and clinical and biochemical indicators of liver function in BA, and to examine the role of PVV in the postoperative surveillance of these patients. Methods: Twenty-nine children (mean age, 8 years 4 months) who had PE for BA underwent Doppler ultrasonography to evaluate PVV. Using regression analysis, these findings were correlated with biochemical indicators of liver function. The Mann-Whitney test was used to detect any significant differences in PVV between the Child-Pugh A group and combined Child-Pugh B and C group patients. Results: The mean [plusmn] SD PVV for the Child-Pugh A group and the combined Child-Pugh B and C group was 17.1 cm/s [plusmn] 8.9 cm/s and 10.2 cm/s [plusmn] 3.3 cm/s, respectively, and this difference was statistically significant (P = .037). Conclusions: Doppler ultrasonography measurement of PVV provides adjunctive information to the clinical and biochemical assessment of the liver function status in BA. Its use in the postoperative surveillance of these patients is helpful in identifying the need for and in timing of liver transplantation. J Pediatr Surg 37:873-876.