The other 28 patients who were followed up for at least 5 years postoperatively were enrolled in cohort B, which represented the period of the regional pilot study of the stool card screening program in Taiwan. Seventy-five BA patients were born between 2004 and 2005. After excluding one patient without Kasai operation, the 74 patients who were followed up for at least 3 years postoperatively were enrolled in cohort C, which represented the

nationwide screening data in Taiwan. Cohort B+C was the merged data of cohorts B and C and represented the era of the stool color card screening program. Statistical analyses were performed using Stata software (StataCorp LP, College Station, TX). A chi-square test was used to compare categorical variables, including age at Kasai operation <60 days, jaundice-free rates at 3 months after Kasai DNA-PK inhibitor operation, 3- JNK inhibitor and 5-year survival rates with native liver, 3- and 5-year jaundice-free survival rates with native liver, and 3-year and 5-year overall survival rates between different cohorts. Overall survival included those patients who survived with either their native liver

or a transplanted liver. Jaundice-free was defined as total serum bilirubin <2.0 mg/dL (34 μmol/L). Quality outcome was defined as jaundice-free survival with native liver. All survival time was calculated after the date of the Kasai operation. Relative odds ratios were computed using logistic regression models to compare the different factors affecting survival time. The Kaplan-Meier method and a log-rank test were also used to assess factors affecting survival. P < 0.05 was considered statistically significant. From 1990 until now, there was no systemic change in post-Kasai operation care except for the concept of prophylactic antibiotics use in Taiwan. Since 1997, most patients have been prescribed

medchemexpress with prophylactic antibiotics after operation. The data of the use of prophylactic antibiotics are collected by chart review, and this possible confounding factor is taken into consideration for analyses. The regimen of prophylactic antibiotics is trimethoprim-sulfamethoxazole (TMP-SMZ, 7 days per week) or neomycin (4 days per week). Our previous study reveals the superior effect of using prophylactic antibiotic versus not using it, and the equal effect for the prophylaxis of cholangitis between the two antibiotic regimens.9 There was no significant difference in the sex distribution between cohort A and cohort (B+C). The rates of Kasai operation performed before 60 days of age were 49.4% in cohort A and 65.7% in cohort B+C (P = 0.02). At 3 months after Kasai operation, the jaundice-free rate was significantly higher in cohort B+C than in cohort A (60.8% versus 34.8%; P < 0.001). The 3-year survival rates with native liver in cohort A and cohort B+C were 51.7% and 61.8%, respectively. The 3-year jaundice-free survival rate with native liver was significantly higher in cohort B+C than in cohort A (56.9% versus 31.