Objective：To summarize the status of native liver survival（NLS）in the early stage after Kasai procedure（KP）in patients with biliary atresia（BA），and to analyze the factors associated with early death or liver transplantation（D/LT）after KP. Methods：The clinical data of children with type Ⅲ BA who underwent KP at the Affiliated Children’s Hospital of Nanjing Medical University from May 2020 to May 2024 were collected. The Kaplan-Meier survival analysis was used to summarize the characteristics of NLS after KP at 1 year postoperatively. Univariate and multivariate Cox regression models were employed to identify associated factors for early D/LT after KP. Results：A total of 105 children with BA who underwent KP were enrolled in the study，with a follow-up period of 12 to 60 months and a median follow-up time of 34 months. Among them，41 cases experienced D/LT，including 35 cases of D/LT within the first year after surgery，accounting for 85.4% of the total D/LT cases. The Kaplan -Meier survival curve estimated an average NLS time of （38.4±2.5）months after KP，with an actual 1-year NLS rate of 66.7% and an estimated 2-year cumulative NLS rate of 59.6%. The estimated 3-5 year cumulative survival rate was consistent with the 2-year cumulative survival rate. Univariate and multivariate Cox regression models revealed that the preoperative liver stiffness measurement（LSM）by ultrasonography and a jaundice clearance（JC） time exceeding 3 months postoperatively are two independent associated factors with early D/LT after the KP[HR（95% CI）：1.031（1.001- 1.064），P=0.049；HR（95% CI）：6.394（3.141- 13.015），P ＜ 0.001]. Among the 105 patients，66（62.9% ）developed cholangitis within 3 months postoperatively，with 18（27.27% ）developing postoperative cholangitis within the first month. A statistically significant difference was observed in the 3-month postoperative JC rates between those with cholangitis developing within 1 month postoperatively，and those with cholangitis developing after 1 month postoperatively（50.0% vs. 77.1%，χ² =4.546，P=0.033）. Conclusion：Most cases of D/LT after KP occur within the first year postoperatively，and a stable NLS state can be achieved by the second year after KP. The preoperative LSM and postoperative JC time are independent associated factors for early D/LT after KP in children with BA. The preoperative LSM was higher than 11.6 kPa，above Metavir F2，and the JC time was greater than 3 months would significantly reduce the rate of early NLS. Postoperative cholangitis within the first month after KP can reduce the JC rate within three months post-KP.