The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study

Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai po...

Full description

Saved in:

Bibliographic Details
Published in:	Pediatric surgery international Vol. 38; no. 2; pp. 193 - 199
Main Authors:	Kelley-Quon, Lorraine I., Shue, Eveline, Burke, Rita V., Smith, Caitlin, Kling, Karen, Mahdi, Elaa, Ourshalimian, Shadassa, Fenlon, Michael, Dellinger, Matthew, Shew, Stephen B., Lee, Justin, Padilla, Benjamin, Inge, Thomas, Roach, Jonathan, Marwan, Ahmed I., Russell, Katie W., Ignacio, Romeo, Fialkowski, Elizabeth, Nijagal, Amar, Im, Cecilia, Azarow, Kenneth S., Ostlie, Daniel J., Wang, Kasper
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2022 Springer Nature B.V
Subjects:	Age Biliary Atresia - surgery Cholangitis Consortia Health Insurance Portability & Accountability Act 1996-US Hospitals Humans Infant Liver Transplantation Liver transplants Medical prognosis Medicine Medicine & Public Health Mortality Original Article Pediatric Surgery Pediatrics Portoenterostomy, Hepatic Retrospective Studies Steroids Surgery Thoracic surgery Treatment Outcome Variables Liver transplant Kasai portoenterostomy Biliary atresia Transplant-free survival
ISSN:	0179-0358, 1437-9813, 1437-9813
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Abstract	Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance. Results Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99). Conclusion Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes.
AbstractList	PurposeThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.MethodsA multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.ResultsOverall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99).ConclusionEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.PURPOSEThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.A multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.METHODSA multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99).RESULTSOverall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99).Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes.CONCLUSIONEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. A multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance. Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99). Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance. Results Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99). Conclusion Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes.
Author	Im, Cecilia Inge, Thomas Ostlie, Daniel J. Smith, Caitlin Azarow, Kenneth S. Ourshalimian, Shadassa Nijagal, Amar Kling, Karen Mahdi, Elaa Shew, Stephen B. Shue, Eveline Wang, Kasper Dellinger, Matthew Lee, Justin Burke, Rita V. Fenlon, Michael Marwan, Ahmed I. Kelley-Quon, Lorraine I. Roach, Jonathan Ignacio, Romeo Russell, Katie W. Fialkowski, Elizabeth Padilla, Benjamin
AuthorAffiliation	e Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA a Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA i Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR d Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine, San Diego, CA h Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital, Salt Lake City, UT j Division of Pediatric Surgery, University of California, San Francisco, San Francisco, CA g Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado, Aurora, CO c Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, Seattle WA and Department of Surgery, University of Washington School of Medicine, Seattle, WA b Department
AuthorAffiliation_xml	– name: c Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, Seattle WA and Department of Surgery, University of Washington School of Medicine, Seattle, WA – name: f Division of Surgery, Phoenix Children’s Hospital, Phoenix, AZ – name: h Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital, Salt Lake City, UT – name: b Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA – name: d Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine, San Diego, CA – name: e Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA – name: g Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado, Aurora, CO – name: j Division of Pediatric Surgery, University of California, San Francisco, San Francisco, CA – name: i Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR – name: a Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA
Author_xml	– sequence: 1 givenname: Lorraine I. orcidid: 0000-0002-1735-0897 surname: Kelley-Quon fullname: Kelley-Quon, Lorraine I. email: lkquon@chla.usc.edu organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California – sequence: 2 givenname: Eveline surname: Shue fullname: Shue, Eveline organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 3 givenname: Rita V. surname: Burke fullname: Burke, Rita V. organization: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California – sequence: 4 givenname: Caitlin surname: Smith fullname: Smith, Caitlin organization: Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children’s Hospital, University of Washington School of Medicine – sequence: 5 givenname: Karen surname: Kling fullname: Kling, Karen organization: Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine – sequence: 6 givenname: Elaa surname: Mahdi fullname: Mahdi, Elaa organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 7 givenname: Shadassa surname: Ourshalimian fullname: Ourshalimian, Shadassa organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 8 givenname: Michael surname: Fenlon fullname: Fenlon, Michael organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 9 givenname: Matthew surname: Dellinger fullname: Dellinger, Matthew organization: Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children’s Hospital, University of Washington School of Medicine – sequence: 10 givenname: Stephen B. surname: Shew fullname: Shew, Stephen B. organization: Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine – sequence: 11 givenname: Justin surname: Lee fullname: Lee, Justin organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 12 givenname: Benjamin surname: Padilla fullname: Padilla, Benjamin organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 13 givenname: Thomas surname: Inge fullname: Inge, Thomas organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 14 givenname: Jonathan surname: Roach fullname: Roach, Jonathan organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 15 givenname: Ahmed I. surname: Marwan fullname: Marwan, Ahmed I. organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 16 givenname: Katie W. surname: Russell fullname: Russell, Katie W. organization: Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital – sequence: 17 givenname: Romeo surname: Ignacio fullname: Ignacio, Romeo organization: Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine – sequence: 18 givenname: Elizabeth surname: Fialkowski fullname: Fialkowski, Elizabeth organization: Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University – sequence: 19 givenname: Amar surname: Nijagal fullname: Nijagal, Amar organization: Division of Pediatric Surgery, University of California – sequence: 20 givenname: Cecilia surname: Im fullname: Im, Cecilia organization: Division of Pediatric Surgery, University of California – sequence: 21 givenname: Kenneth S. surname: Azarow fullname: Azarow, Kenneth S. organization: Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University – sequence: 22 givenname: Daniel J. surname: Ostlie fullname: Ostlie, Daniel J. organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 23 givenname: Kasper surname: Wang fullname: Wang, Kasper organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/34854975$$D View this record in MEDLINE/PubMed
BookMark	eNp9kUtvEzEUhS1URNPCH2CBLLFhM-BnbLNAQhEvUQkERSyNM3OncTWxU3sGaf49N6QU6KIry_J3rs-554QcpZyAkMecPeeMmReVMWllwwRvmGbKNPweWXAlTeMsl0dkwbhxDZPaHpOTWi8ZY1Yu3QNyLJXVyhm9ID_ON0ATQEf7XCiEMsz0Y6gh0l0uY4Y0Qsl1zNv5JQ30O1S8J_oZuhjGElv6dSoXUGb6BSqK2w1d5VRRGactrePUzQ_J_T4MFR5dn6fk29s356v3zdmndx9Wr8-aVhk1NiB7qY3QQivVBWaEdG4puRIcnOBrxfDZCtU7i9kgBN33_VqHDpSTQsFanpJXh7m7ab2FrkXnJQx-V-I2lNnnEP3_Lylu_EX-6a1RwliFA55dDyj5asKgfhtrC8MQEuSperFkWuPOxB59egu9zFNJGA8pbqxT1kiknvzr6MbKn-UjIA5AiyuuBfobhDO_b9gfGvbYsP_dsOcosrdEbRzDGPM-VRzulsqDtOI_CWv7a_sO1S8OH7rA
CitedBy_id	crossref_primary_10_1007_s11306_024_02175_2 crossref_primary_10_1038_s41572_024_00533_x crossref_primary_10_3748_wjg_v31_i33_108369 crossref_primary_10_1186_s12887_025_05780_9 crossref_primary_10_4292_wjgpt_v13_i4_33 crossref_primary_10_1097_MPG_0000000000003943 crossref_primary_10_1016_j_jpedsurg_2025_162250 crossref_primary_10_1016_j_jpedsurg_2023_01_003 crossref_primary_10_1016_j_jpedsurg_2024_03_005 crossref_primary_10_1016_j_sempedsurg_2025_151479 crossref_primary_10_1111_apa_17493 crossref_primary_10_1002_jpn3_12367 crossref_primary_10_1007_s00383_025_06021_x crossref_primary_10_3389_fped_2023_1278978 crossref_primary_10_5500_wjt_v14_i1_88734 crossref_primary_10_1007_s00383_022_05227_7 crossref_primary_10_1016_j_jpedsurg_2025_162244 crossref_primary_10_1097_HEP_0000000000000835
Cites_doi	10.1016/s0140-6736(09)60946-6 10.1016/j.jhep.2019.03.005 10.1186/s12887-018-1074-2 10.1097/MOP.0000000000000214 10.1016/j.jpedsurg.2018.09.025 10.1016/j.jhep.2013.01.040 10.1097/mpg.0b013e3181d67e5e 10.1016/j.jpedsurg.2011.04.013 10.1001/jama.2020.0837 10.1542/peds.2007-2709 10.1542/peds.2008-1949 10.1016/j.ejso.2016.06.392 10.1016/S0140-6736(99)03492-3 10.1016/j.jpedsurg.2021.02.027 10.1016/j.jamcollsurg.2017.09.009 10.1097/SLA.0b013e3182300950 10.1007/s11605-013-2422-z 10.1016/j.jpeds.2017.05.006 10.1016/j.amjsurg.2015.08.021 10.1002/lt.24640 10.1097/mpg.0000000000002446
ContentType	Journal Article
Copyright	The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.
Copyright_xml	– notice: The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 – notice: 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. – notice: The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.
DBID	AAYXX CITATION CGR CUY CVF ECM EIF NPM 3V. 7RV 7X7 7XB 88E 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR CCPQU FYUFA GHDGH K9- K9. KB0 M0R M0S M1P NAPCQ PHGZM PHGZT PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI PRINS 7X8 5PM
DOI	10.1007/s00383-021-05047-1
DatabaseName	CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed ProQuest Central (Corporate) Nursing & Allied Health Database Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central Essentials ProQuest Central ProQuest One Health Research Premium Collection Health Research Premium Collection (Alumni) Consumer Health Database ProQuest Health & Medical Complete (Alumni) Nursing & Allied Health Database (Alumni Edition) Consumer Health Database Health & Medical Collection (Alumni Edition) PML(ProQuest Medical Library) Nursing & Allied Health Premium ProQuest Central Premium ProQuest One Academic ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic (retired) ProQuest One Academic UKI Edition ProQuest Central China MEDLINE - Academic PubMed Central (Full Participant titles)
DatabaseTitle	CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Family Health (Alumni Edition) ProQuest Central China ProQuest Central ProQuest Health & Medical Research Collection Health Research Premium Collection Health and Medicine Complete (Alumni Edition) Health & Medical Research Collection ProQuest Central (New) ProQuest Medical Library (Alumni) ProQuest Family Health ProQuest One Academic Eastern Edition ProQuest Nursing & Allied Health Source ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest Medical Library ProQuest One Academic UKI Edition ProQuest Nursing & Allied Health Source (Alumni) ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) MEDLINE - Academic
DatabaseTitleList	ProQuest One Academic Middle East (New) MEDLINE - Academic MEDLINE
Database_xml	– sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7RV name: Nursing & Allied Health Database url: https://search.proquest.com/nahs sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Medicine
EISSN	1437-9813
EndPage	199
ExternalDocumentID	PMC8742784 34854975 10_1007_s00383_021_05047_1
Genre	Multicenter Study Journal Article
GrantInformation_xml	– fundername: NCATS NIH HHS grantid: KL2 TR001854
GroupedDBID	--- -53 -5E -5G -BR -EM -Y2 -~C .86 .GJ .VR 06C 06D 0R~ 0VY 123 1N0 1SB 2.D 203 28- 29O 29~ 2J2 2JN 2JY 2KG 2KM 2LR 2P1 2VQ 2~H 30V 36B 3O- 3V. 4.4 406 408 409 40D 40E 53G 5QI 5RE 5VS 67Z 6NX 7RV 7X7 88E 8FI 8FJ 8TC 8UJ 95- 95. 95~ 96X AAAVM AABHQ AACDK AAHNG AAIAL AAJBT AAJKR AANXM AANZL AAPKD AARHV AARTL AASML AATNV AATVU AAUYE AAWCG AAYIU AAYQN AAYTO AAYZH ABAKF ABBBX ABBXA ABDZT ABECU ABFTV ABHLI ABHQN ABIPD ABJNI ABJOX ABKCH ABKTR ABLJU ABMNI ABMQK ABNWP ABPLI ABPPZ ABQBU ABQSL ABSXP ABTEG ABTKH ABTMW ABULA ABUWG ABUWZ ABWNU ABXPI ACAOD ACBXY ACDTI ACGFS ACHSB ACHXU ACKNC ACMDZ ACMLO ACOKC ACOMO ACPIV ACUDM ACZOJ ADBBV ADHHG ADHIR ADIMF ADINQ ADJJI ADKNI ADKPE ADRFC ADTPH ADURQ ADYFF ADZKW AEBTG AEFIE AEFQL AEGAL AEGNC AEJHL AEJRE AEKMD AEMSY AENEX AEOHA AEPYU AESKC AETLH AEVLU AEXYK AFBBN AFEXP AFKRA AFLOW AFQWF AFWTZ AFZKB AGAYW AGDGC AGGDS AGJBK AGMZJ AGQEE AGQMX AGRTI AGWIL AGWZB AGYKE AHAVH AHBYD AHIZS AHKAY AHMBA AHSBF AHYZX AIAKS AIGIU AIIXL AILAN AITGF AJBLW AJRNO AJZVZ AKMHD ALIPV ALMA_UNASSIGNED_HOLDINGS ALWAN AMKLP AMXSW AMYLF AMYQR AOCGG ARMRJ ASPBG AVWKF AXYYD AZFZN AZQEC B-. BA0 BBWZM BDATZ BENPR BGNMA BKEYQ BKNYI BPHCQ BSONS BVXVI CAG CCPQU COF CS3 CSCUP DDRTE DL5 DNIVK DPUIP DU5 EBD EBLON EBS EIOEI EJD EMB EMOBN EN4 ESBYG EX3 F5P FEDTE FERAY FFXSO FIGPU FINBP FNLPD FRRFC FSGXE FWDCC FYUFA G-Y G-Z GGCAI GGRSB GJIRD GNWQR GQ6 GQ7 GQ8 GRRUI GXS H13 HF~ HG5 HG6 HMCUK HMJXF HQYDN HRMNR HVGLF HZ~ I09 IHE IJ- IKXTQ IMOTQ ITM IWAJR IXC IZIGR IZQ I~X I~Z J-C J0Z JBSCW JCJTX JZLTJ K9- KDC KOV KOW KPH L7B LAS LLZTM M0R M1P M4Y MA- N2Q N9A NAPCQ NB0 NDZJH NPVJJ NQJWS NU0 O9- O93 O9G O9I O9J OAM P19 P2P P9S PF0 PQQKQ PROAC PSQYO PT4 PT5 Q2X QOK QOR QOS R4E R89 R9I RHV RIG RNI ROL RPX RRX RSV RZK S16 S1Z S26 S27 S28 S37 S3B SAP SCLPG SDE SDH SDM SHX SISQX SJYHP SMD SNE SNPRN SNX SOHCF SOJ SPISZ SRMVM SSLCW SSXJD STPWE SV3 SZ9 SZN T13 T16 TSG TSK TSV TT1 TUC U2A U9L UG4 UKHRP UOJIU UTJUX UZXMN VC2 VFIZW W23 W48 WJK WK8 WOW YLTOR Z45 Z7U Z82 Z87 Z8O Z8V Z91 ZGI ZMTXR ZOVNA ~EX AAPKM AAYXX ABBRH ABDBE ABFSG ABRTQ ACSTC ADHKG AEZWR AFDZB AFFHD AFHIU AFOHR AGQPQ AHPBZ AHWEU AIXLP ATHPR AYFIA CITATION PHGZM PHGZT PJZUB PPXIY CGR CUY CVF ECM EIF NPM 7XB 8FK K9. PKEHL PQEST PQUKI PRINS 7X8 PUEGO 5PM
ID	FETCH-LOGICAL-c474t-e3f357252544da072399631421e921b40f35824f98981eaa5fffb5ade49324eb3
IEDL.DBID	7RV
ISICitedReferencesCount	17
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000725385300002&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	0179-0358 1437-9813
IngestDate	Tue Nov 04 02:06:43 EST 2025 Fri Sep 05 12:44:38 EDT 2025 Tue Nov 04 23:16:23 EST 2025 Mon Jul 21 05:59:02 EDT 2025 Tue Nov 18 21:16:11 EST 2025 Sat Nov 29 06:05:55 EST 2025 Fri Feb 21 02:46:28 EST 2025
IsDoiOpenAccess	false
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	2
Keywords	Liver transplant Kasai portoenterostomy Biliary atresia Transplant-free survival
Language	English
License	2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c474t-e3f357252544da072399631421e921b40f35824f98981eaa5fffb5ade49324eb3
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Author Contributions: All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Lorraine Kelley-Quon, Rita Burke, Elaa Mahdi, and Shadassa Ourshalimian. The first draft of the manuscript was written by Lorraine Kelley-Quon and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
ORCID	0000-0002-1735-0897
OpenAccessLink	https://www.ncbi.nlm.nih.gov/pmc/articles/8742784
PMID	34854975
PQID	2617894873
PQPubID	30512
PageCount	7
ParticipantIDs	pubmedcentral_primary_oai_pubmedcentral_nih_gov_8742784 proquest_miscellaneous_2605597524 proquest_journals_2617894873 pubmed_primary_34854975 crossref_primary_10_1007_s00383_021_05047_1 crossref_citationtrail_10_1007_s00383_021_05047_1 springer_journals_10_1007_s00383_021_05047_1
PublicationCentury	2000
PublicationDate	2022-02-01
PublicationDateYYYYMMDD	2022-02-01
PublicationDate_xml	– month: 02 year: 2022 text: 2022-02-01 day: 01
PublicationDecade	2020
PublicationPlace	Berlin/Heidelberg
PublicationPlace_xml	– name: Berlin/Heidelberg – name: Germany – name: Berlin
PublicationTitle	Pediatric surgery international
PublicationTitleAbbrev	Pediatr Surg Int
PublicationTitleAlternate	Pediatr Surg Int
PublicationYear	2022
Publisher	Springer Berlin Heidelberg Springer Nature B.V
Publisher_xml	– name: Springer Berlin Heidelberg – name: Springer Nature B.V
References	Fanna, Masson, Capito (CR7) 2019; 69 Harpavat, Garcia-Prats, Anaya (CR6) 2020; 323 Wadhwani, Turmelle, Nagy, Lowell, Dillon, Shepherd (CR8) 2008; 121 Hartley, Davenport, Kelly (CR2) 2009; 374 Al-Qurayshi, Robins, Buell, Kandil (CR18) 2016; 42 Enomoto, Gusani, Dillon, Hollenbeak (CR20) 2013; 18 Hukkinen, Kerola, Lohi (CR16) 2018; 226 Lai, Chen, Chen, Hung, Chang (CR12) 2006; 29 Toomey, Teta, Patel, Ross, Rosemurgy (CR19) 2016; 211 Serinet, Wildhaber, Broue (CR5) 2009; 123 Chen, Lin, Tsan (CR11) 2018; 18 Sundaram, Mack, Feldman, Sokol (CR21) 2017; 23 McKiernan, Baker, Kelly (CR14) 2000; 355 Superina, Magee, Brandt (CR1) 2011; 254 Zagory, Nguyen, Wang (CR4) 2015; 27 Davenport, Ong, Sharif (CR15) 2011; 46 Apfeld, Cooper, Sebastião, Tiao, Minneci, Deans (CR22) 2021; 56 Chardot, Buet, Serinet (CR10) 2013; 58 Jain, Burford, Alexander (CR13) 2019; 71 Hopkins, Yazigi, Nylund (CR3) 2017; 187 Wang, Chen, Peng (CR9) 2019; 54 Schreiber, Barker, Roberts, Martin (CR17) 2010; 51 R Superina (5047_CR1) 2011; 254 LM Enomoto (5047_CR20) 2013; 18 C Chardot (5047_CR10) 2013; 58 M-O Serinet (5047_CR5) 2009; 123 PJ McKiernan (5047_CR14) 2000; 355 SS Sundaram (5047_CR21) 2017; 23 RA Schreiber (5047_CR17) 2010; 51 S-Y Chen (5047_CR11) 2018; 18 S Harpavat (5047_CR6) 2020; 323 JC Apfeld (5047_CR22) 2021; 56 M Fanna (5047_CR7) 2019; 69 Z Wang (5047_CR9) 2019; 54 PG Toomey (5047_CR19) 2016; 211 JL Hartley (5047_CR2) 2009; 374 V Jain (5047_CR13) 2019; 71 SI Wadhwani (5047_CR8) 2008; 121 M Davenport (5047_CR15) 2011; 46 JA Zagory (5047_CR4) 2015; 27 Z Al-Qurayshi (5047_CR18) 2016; 42 H-S Lai (5047_CR12) 2006; 29 M Hukkinen (5047_CR16) 2018; 226 PC Hopkins (5047_CR3) 2017; 187
References_xml	– volume: 374 start-page: 1704 issue: 9702 year: 2009 end-page: 1713 ident: CR2 article-title: Biliary atresia publication-title: Lancet doi: 10.1016/s0140-6736(09)60946-6 – volume: 71 start-page: 71 issue: 1 year: 2019 end-page: 77 ident: CR13 article-title: Prognostic markers at adolescence in patients requiring liver transplantation for biliary atresia in adulthood publication-title: J Hepatol doi: 10.1016/j.jhep.2019.03.005 – volume: 18 start-page: 119 issue: 1 year: 2018 ident: CR11 article-title: Number of cholangitis episodes as a prognostic marker to predict timing of liver transplantation in biliary atresia patients after Kasai portoenterostomy publication-title: BMC Pediatr doi: 10.1186/s12887-018-1074-2 – volume: 27 start-page: 389 issue: 3 year: 2015 end-page: 394 ident: CR4 article-title: Recent advances in the pathogenesis and management of biliary atresia publication-title: Curr Opin Pediatr doi: 10.1097/MOP.0000000000000214 – volume: 54 start-page: 1680 issue: 8 year: 2019 end-page: 1685 ident: CR9 article-title: Five-year native liver survival analysis in biliary atresia from a single large Chinese center: the death/liver transplantation hazard change and the importance of rapid early clearance of jaundice publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2018.09.025 – volume: 58 start-page: 1209 issue: 6 year: 2013 end-page: 1217 ident: CR10 article-title: Improving outcomes of biliary atresia: French national series 1986–2009 publication-title: J Hepatol doi: 10.1016/j.jhep.2013.01.040 – volume: 51 start-page: 61 issue: 1 year: 2010 end-page: 65 ident: CR17 article-title: Biliary atresia in Canada: the effect of centre caseload experience on outcome publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0b013e3181d67e5e – volume: 46 start-page: 1689 issue: 9 year: 2011 end-page: 1694 ident: CR15 article-title: Biliary atresia in England and Wales: results of centralization and new benchmark publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2011.04.013 – volume: 323 start-page: 1141 issue: 12 year: 2020 end-page: 1150 ident: CR6 article-title: Diagnostic yield of newborn screening for biliary atresia using direct or conjugated bilirubin measurements publication-title: JAMA doi: 10.1001/jama.2020.0837 – volume: 121 start-page: e1438LP issue: 5 year: 2008 end-page: e1440 ident: CR8 article-title: Prolonged neonatal jaundice and the diagnosis of biliary atresia: a single-center analysis of trends in age at diagnosis and outcomes publication-title: Pediatrics doi: 10.1542/peds.2007-2709 – volume: 123 start-page: 1280 issue: 5 year: 2009 end-page: 1286 ident: CR5 article-title: Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening publication-title: Pediatrics doi: 10.1542/peds.2008-1949 – volume: 42 start-page: 1483 issue: 10 year: 2016 end-page: 1490 ident: CR18 article-title: Surgeon volume impact on outcomes and cost of adrenal surgeries publication-title: Eur J Surg Oncol doi: 10.1016/j.ejso.2016.06.392 – volume: 355 start-page: 25 issue: 9197 year: 2000 end-page: 29 ident: CR14 article-title: The frequency and outcome of biliary atresia in the UK and Ireland publication-title: Lancet (London, England) doi: 10.1016/S0140-6736(99)03492-3 – volume: 56 start-page: 1196 issue: 6 year: 2021 end-page: 1202 ident: CR22 article-title: Variability in age at Kasai portoenterostomy for biliary atresia across US children’s hospitals publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2021.02.027 – volume: 226 start-page: 46 issue: 1 year: 2018 end-page: 57.e1 ident: CR16 article-title: Treatment policy and liver histopathology predict biliary atresia outcomes: results after national centralization and protocol biopsies publication-title: J Am Coll Surg doi: 10.1016/j.jamcollsurg.2017.09.009 – volume: 254 start-page: 577 issue: 4 year: 2011 end-page: 585 ident: CR1 article-title: The anatomic pattern of biliary atresia identified at time of Kasai hepatoportoenterostomy and early postoperative clearance of jaundice are significant predictors of transplant-free survival publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182300950 – volume: 18 start-page: 690 issue: 4 year: 2013 end-page: 700 ident: CR20 article-title: Impact of surgeon and hospital volume on mortality, length of stay, and cost of pancreaticoduodenectomy publication-title: J Gastrointest Surg doi: 10.1007/s11605-013-2422-z – volume: 187 start-page: 253 year: 2017 end-page: 257 ident: CR3 article-title: Incidence of biliary atresia and timing of hepatoportoenterostomy in the United States publication-title: J Pediatr doi: 10.1016/j.jpeds.2017.05.006 – volume: 211 start-page: 59 issue: 1 year: 2016 end-page: 63 ident: CR19 article-title: High-volume surgeons vs high-volume hospitals: are best outcomes more due to who or where? publication-title: Am J Surg doi: 10.1016/j.amjsurg.2015.08.021 – volume: 23 start-page: 96 issue: 1 year: 2017 end-page: 109 ident: CR21 article-title: Biliary atresia: indications and timing of liver transplantation and optimization of pretransplant care publication-title: Liver Transpl doi: 10.1002/lt.24640 – volume: 69 start-page: 416 issue: 4 year: 2019 end-page: 424 ident: CR7 article-title: Management of biliary atresia in France 1986 to 2015: long-term results publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0000000000002446 – volume: 29 start-page: 234 issue: 3 year: 2006 end-page: 239 ident: CR12 article-title: Long-term prognosis and factors affecting biliary atresia from experience over a 25 year period publication-title: Chang Gung Med J – volume: 42 start-page: 1483 issue: 10 year: 2016 ident: 5047_CR18 publication-title: Eur J Surg Oncol doi: 10.1016/j.ejso.2016.06.392 – volume: 58 start-page: 1209 issue: 6 year: 2013 ident: 5047_CR10 publication-title: J Hepatol doi: 10.1016/j.jhep.2013.01.040 – volume: 29 start-page: 234 issue: 3 year: 2006 ident: 5047_CR12 publication-title: Chang Gung Med J – volume: 69 start-page: 416 issue: 4 year: 2019 ident: 5047_CR7 publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0000000000002446 – volume: 374 start-page: 1704 issue: 9702 year: 2009 ident: 5047_CR2 publication-title: Lancet doi: 10.1016/s0140-6736(09)60946-6 – volume: 254 start-page: 577 issue: 4 year: 2011 ident: 5047_CR1 publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182300950 – volume: 226 start-page: 46 issue: 1 year: 2018 ident: 5047_CR16 publication-title: J Am Coll Surg doi: 10.1016/j.jamcollsurg.2017.09.009 – volume: 18 start-page: 119 issue: 1 year: 2018 ident: 5047_CR11 publication-title: BMC Pediatr doi: 10.1186/s12887-018-1074-2 – volume: 323 start-page: 1141 issue: 12 year: 2020 ident: 5047_CR6 publication-title: JAMA doi: 10.1001/jama.2020.0837 – volume: 23 start-page: 96 issue: 1 year: 2017 ident: 5047_CR21 publication-title: Liver Transpl doi: 10.1002/lt.24640 – volume: 18 start-page: 690 issue: 4 year: 2013 ident: 5047_CR20 publication-title: J Gastrointest Surg doi: 10.1007/s11605-013-2422-z – volume: 123 start-page: 1280 issue: 5 year: 2009 ident: 5047_CR5 publication-title: Pediatrics doi: 10.1542/peds.2008-1949 – volume: 54 start-page: 1680 issue: 8 year: 2019 ident: 5047_CR9 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2018.09.025 – volume: 56 start-page: 1196 issue: 6 year: 2021 ident: 5047_CR22 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2021.02.027 – volume: 187 start-page: 253 year: 2017 ident: 5047_CR3 publication-title: J Pediatr doi: 10.1016/j.jpeds.2017.05.006 – volume: 355 start-page: 25 issue: 9197 year: 2000 ident: 5047_CR14 publication-title: Lancet (London, England) doi: 10.1016/S0140-6736(99)03492-3 – volume: 211 start-page: 59 issue: 1 year: 2016 ident: 5047_CR19 publication-title: Am J Surg doi: 10.1016/j.amjsurg.2015.08.021 – volume: 51 start-page: 61 issue: 1 year: 2010 ident: 5047_CR17 publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0b013e3181d67e5e – volume: 121 start-page: e1438LP issue: 5 year: 2008 ident: 5047_CR8 publication-title: Pediatrics doi: 10.1542/peds.2007-2709 – volume: 27 start-page: 389 issue: 3 year: 2015 ident: 5047_CR4 publication-title: Curr Opin Pediatr doi: 10.1097/MOP.0000000000000214 – volume: 71 start-page: 71 issue: 1 year: 2019 ident: 5047_CR13 publication-title: J Hepatol doi: 10.1016/j.jhep.2019.03.005 – volume: 46 start-page: 1689 issue: 9 year: 2011 ident: 5047_CR15 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2011.04.013
SSID	ssj0008369
Score	2.4120278
Snippet	Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A... The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. A multi-institutional,... PurposeThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.MethodsA multi-institutional,... The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.PURPOSEThe purpose of this study was...
SourceID	pubmedcentral proquest pubmed crossref springer
SourceType	Open Access Repository Aggregation Database Index Database Enrichment Source Publisher
StartPage	193
SubjectTerms	Age Biliary Atresia - surgery Cholangitis Consortia Health Insurance Portability & Accountability Act 1996-US Hospitals Humans Infant Liver Transplantation Liver transplants Medical prognosis Medicine Medicine & Public Health Mortality Original Article Pediatric Surgery Pediatrics Portoenterostomy, Hepatic Retrospective Studies Steroids Surgery Thoracic surgery Treatment Outcome Variables
SummonAdditionalLinks	– databaseName: SpringerLINK Contemporary 1997-Present dbid: RSV link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ZS8QwEB5ERXzxPqqrRPBNC22TmNQ3EUVQF_Hct5qtCS5oK3ZX8N-bSQ9ZVwV9TprmmCQTZr7vA9iOUbo4Cpgv4jTwmRKpPQej2Kdac9o1WsnUqZaciXZbdjrxRQUKK-ps9zok6U7qBuyGQSyMOdrnL0d-AfvmmbDXnUTBhsur2-b8ldQJ2aGp-QHlsoLKfN_G8HU04mOOpkp-iZe6a-h49n8DmIOZyu0kB6WdzMOYzhZg6rwKrC_CvTUXktmbjFgnlmhkPSanqlA9gv55jsSdCA_Jn9_3iSJ3Jb0CaXQ-yFWJriZ1Ih9BIVD7ZW_wTByD7RLcHB9dH574lfiCnzLB-r6mhnIRcaQwe1CBQAzsHg1ZFOo4CrssMIixZQb1J0OtFDfGdLl60Mx6hMw-0ZdhPMszvQrE0EBaKwiRiIbF0sShkpxbzwJhXyzVHoT1GiRpxUyOAhlPScOp7KYusVOXuKlLQg92mm9eSl6OX2u36qVNqj1aJMhFL22fBPVgqym2uwtDJirT-QDrBPjk4hHzYKW0hOZ31A1HcA_EkI00FZC5e7gk6z06Bm8pUOHEtrlbW8pnt34exdrfqq_DdIRYDZdi3oLx_utAb8Bk-tbvFa-bbs98AMPKDpc priority: 102 providerName: Springer Nature
Title	The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study
URI	https://link.springer.com/article/10.1007/s00383-021-05047-1 https://www.ncbi.nlm.nih.gov/pubmed/34854975 https://www.proquest.com/docview/2617894873 https://www.proquest.com/docview/2605597524 https://pubmed.ncbi.nlm.nih.gov/PMC8742784
Volume	38
WOSCitedRecordID	wos000725385300002&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVPQU databaseName: Nursing & Allied Health Database customDbUrl: eissn: 1437-9813 dateEnd: 20241212 omitProxy: false ssIdentifier: ssj0008369 issn: 0179-0358 databaseCode: 7RV dateStart: 19970201 isFulltext: true titleUrlDefault: https://search.proquest.com/nahs providerName: ProQuest – providerCode: PRVAVX databaseName: SpringerLINK Contemporary 1997-Present customDbUrl: eissn: 1437-9813 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0008369 issn: 0179-0358 databaseCode: RSV dateStart: 19970101 isFulltext: true titleUrlDefault: https://link.springer.com/search?facet-content-type=%22Journal%22 providerName: Springer Nature
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LT9wwEB7xqBCXFsorFJCReisRcWzXTi9Vi0CVWlZoaWFvwZu1xUqQALuLxL_H4zhBC4JLL5Yi20lGM7bHHs_3AXzOkLo4TXgssyKJuZaFmwfTLGbGCNa3RqvCs5b8kZ2O6vWyk3DgNgrXKps50U_Ug6rAM_J9RA5XmXOv2feb2xhZozC6Gig0ZmGeom_s7Fl2z9qZWDFPaYdGFydMqJA041PnMCSGEUy3mRaIVkCnF6YX3ubLS5PPIqd-QTr68L-iLMH74IqSH7XtLMOMKT_CwnEItq_AhTMhUrrVjTjHlhhEQia_9UgPCfrsFYJ5YspIdf3wjWhyXkMukJb7g5zWGdekudxHkBzU9RxOrolHtV2Ff0eHfw9-xYGQIS645OPYMMuETAXCmg10IjEv9iujPKUmS2mfJxbzbrlFTkpqtBbW2r7QA8Odl8jdtn0N5sqqNBtALEuUswyK4DQ8UzajWgnhvA1MBeOFiYA22siLgFaOpBlXeYuz7DWYOw3mXoM5jeBL2-emxup4s_VWo508jNtR_qSaCHbbajfiMIyiS1NNsE2C2zCR8gjWa5toP8e8OFJEIKespW2AaN7TNeXw0qN6K4msJ-6de41dPf3W61Jsvi3FJ1hMMV_DXzPfgrnx3cRsw7vifjwc3e340YJlT_pS7cD8z8POSdc9HSdYdk_PHgGQOR53
linkProvider	ProQuest
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1LT9wwEB5RWrW99AF9pIVipHKCqLFj10mlqqp4CLTLCgkQewverK2uVBLK7rbiT_U3dsZ5oC2CGwfOcZx483k8szPzfQAfU5IuFpEMdZpHoTQ6Rzso0jC2VsUDZ02Se9WSru71kn4_PZiDv00vDJVVNjbRG-phmdN_5J-IOTxJ0b2Ov53_Ckk1irKrjYRGBYuOvfyDIdv4694Wft81IXa2jzZ3w1pVIMyllpPQxi5WWiji5hqaSFNz5-eYS8FtKvhARo6aR6UjYUVujVHOuYEyQyvR1ZEYe-K8D-Ah2nFNwZ7utwEeET17dxtBHkY4S92k41v1KAVHGVMM3hWxI_DZg_Cad3u9SPO_TK0_AHee37ef7gU8q11t9r3aGy9hzhYL8Hi_LiZYhFPcIqzA05uh484sMT2zjhmbEaOYpCSyUmqJKc8uvzDDTipKCdZqm7DDqqOcNcWLjMRP8c7R9Ix51t5XcHwn63sN80VZ2LfAXBwliHxO5DsyTVzKTaIUelPU6iZzGwBvvn6W12zsJAryM2t5pD1iMkRM5hGT8QDW23vOKy6SW0cvNWjIars0zq6gEMBqexktCqWJTGHLKY2JKMxUQgbwpsJg-7jYL0erAPQMOtsBxFY-e6UY_fCs5YkmVRecc6PB8dVr3byKd7evYgWe7B7td7PuXq_zHp4K6k3xJfVLMD-5mNpleJT_nozGFx_8TmVwetf4_gdxr3NX
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB6VgiouvAvpA4wEJ4gav-oECaGKsqLadlXxEL2l3qwtVqJJ291t1b_Gr2PGeVRLRW89cI7jxLufxzOZme8DeJWRdLFIVGyyIomVNQXaQZHF0jkth97ZtAiqJbtmMEgPDrL9Bfjd9sJQWWVrE4OhHlUFfSPfIObwNEP3Wm74pixif7v34fgkJgUpyrS2cho1RPru4hzDt8n7nW38r18L0fv07ePnuFEYiAtl1DR20ktthCaerpFNDDV6bkquBHeZ4EOVeGokVZ5EFrmzVnvvh9qOnEK3R2EcivPegttGaUG8_XvJl-4USGWQ0yPAxwnO0jTshLY9SsdR9hQDeU1MCXz-ULzi6V4t2PwraxsOw979__lnfAD3GhecbdV75iEsuPIRLO01RQaP4RC3DivxVGfo0DNHDNCsbyd2zChWqYjElFplqqOLd8yyHzXVBOs0T9jXutOctUWNjERR8c7x7IgFNt8n8P1G1rcMi2VVumfAvExS3BGcSHlUlvqM21Rr9LKoBU4VLgLeIiEvGpZ2Egv5lXf80gE9OaInD-jJeQRvunuOa46Sa0evtcjIG3s1yS9hEcHL7jJaGkof2dJVMxqTUPiJUI_gaY3H7nEyLMfoCMwcUrsBxGI-f6Uc_wxs5qkhtRec822L6cvX-vcqVq5fxQtYQljnuzuD_ircFdSyEirt12Bxejpz63CnOJuOJ6fPw6ZlcHjT8P4Daqx8IA
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=The+need+for+early+Kasai+portoenterostomy%3A+a+Western+Pediatric+Surgery+Research+Consortium+study&rft.jtitle=Pediatric+surgery+international&rft.au=Kelley-Quon%2C+Lorraine+I.&rft.au=Shue%2C+Eveline&rft.au=Burke%2C+Rita+V.&rft.au=Smith%2C+Caitlin&rft.date=2022-02-01&rft.issn=0179-0358&rft.eissn=1437-9813&rft.volume=38&rft.issue=2&rft.spage=193&rft.epage=199&rft_id=info:doi/10.1007%2Fs00383-021-05047-1&rft.externalDBID=n%2Fa&rft.externalDocID=10_1007_s00383_021_05047_1
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0179-0358&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0179-0358&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0179-0358&client=summon