Outcome after unsuccessful Kasai operation
If the Kasai operation fails to restore the bile flow, biliary
cirrhosis progresses and necessitates liver transplantation.
This is usually performed in the second year of life but
may be necessary earlier (from 6 months of life) when
there is a rapid aggravation of the liver disease. BA represents
more than half of the indications for liver transplantation
in childhood. Transplantation may also be required
in those cases where recurrence of jaundice (secondary
failure of the Kasai operation) or complications of cirrhosis
(e.g. hepatopulmonary syndrome) occur despite an
initially successful outcome after the Kasai operation.