Introduction: Biliary atresia (BA) is a progressive fibro-obliterative disorder of the intra- and extrahepatic bile ducts, beginning during the first three months of life.  It affects approximately one in 8,000-18,000 live births, worldwide.  The early diagnosis of BA is vitally important for carrying out a Kasai portoenterostomy, which reestablishes bile flow (if it is performed before three months of age), and helps prevent rapid progression of the hepatic lesion and the development of cirrhosis, thus avoiding or postponing liver transplantation.  
Several studies have shown that patients with a prior Kasai have a greater risk of surgical difficulties and complications during and after transplantation, such as intestinal perforations, increased length of the surgical procedure and intensive care unit stay, as well as greater blood loss, postoperative biliary and portal complications.  
Materials and Methods: A retrospective cohort study of patients with a history of biliary atresia and liver transplantation, according to their history of a prior Kasai, at the Fundación CardioiInfantil (FCI) from 2007 to 2017.  
Results and Discussion: Females made up 71.8% of the patients, with a median age of seven months, and an average weight of 8Kg (+/- 5Kg), of whom 59% have had a Kasai performed at a median age of 60 days.  With regard to the transplant, 77% were live donor recipients and 89.7% received partial transplants. There were surgical complications in 38.5% of cases, with 5.1% arterial and 7.7% related to the graft. A total of 89.7% survived. No differences were found in survival (p: 0.63), surgical complications (p:0.92), or graft complications (p:0.56). According to the Kasai history, there were also no differences in age (p:0.51) and weight (p:0.9) at the time of transplantation, nor in time on the waiting list (p:0.32), length of survival (p:0.43) or intraoperative bleeding (p:0.13). The Kaplan-Meier analysis did not show significant differences in the time of death or time on the waiting list, according to the history of Kasai.
Conclusion: In our population, the history of Kasai did not influence clinical behavior, complications, survival or waiting time for liver transplant recipients. Therefore, we will continue to consider it to be a valid bridge or definitive treatment for patients with BA.