Introduction: Biliary atresia(BA); is a congenital obliterative cholangiopathy and is the major cause of obstructive jaundice in neonates. Its etiology is unknown. Introduction of the Kasai operation (hepatic portoenterostomy) contributed to a dramatic improvement in the long-term survival in patients with BA and this procedure is now accepted as the standard surgical technique. Indications for liver transplantation(LT) in patients with post-Kasai BA include liver cirrhosis, liver failure, gastrointestinal bleeding due to portal hypertension, growth retardation, progressive intrapulmonary shunting, hepatopulmonary syndrome and repeated cholangitis, either singly or in combination. In the present study, we want to present our experience about post-Kasai LT.

Materials and Methods: The data of 22 pediatric patients who underwent liver transplant after kasai operation from 2001 to november 2012 at our center were analized retrospectively. All patients were treatedwith the same immunsupration protocol after LT.

Results: We performed 167 pediatric liver transplantation at our center and 30(17,9%) of them were due to BA. Twenty two patients had portoenterostomy operation, before transplantation. One of them were deceased donor LT and 21 of them were living related LT. The mean operation time was 9±1,9 hours. During the transplantation, average need for blood transfusion was 450ml. In the early period after the transplantations; abdominal bleedings was seen in 4 patients, intestinal perforation was seen in 3 patients, chylous ascites was seen in 1 patient, biliary leak was seen in 4 patients and biliary stricture was seen in 4 patients. There was not any donor mortality or major morbidity.

Conclusions: For the management of patients with BA post-Kasai in the modern era, LT should be used for those patients who develop complications or failure of the Kasai operation.