دورية أكاديمية
Inflammation patterns in early post-operative cholangitis predict long-term outcomes in biliary atresia: a potential role of non-suppurative cholangitis.
العنوان: | Inflammation patterns in early post-operative cholangitis predict long-term outcomes in biliary atresia: a potential role of non-suppurative cholangitis. |
---|---|
المؤلفون: | Harumatsu T; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Muraji T; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Masuya R; Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan., Tsuruno Y; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Iwamoto Y; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Ogata M; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Takada L; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Kedoin C; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Nagano A; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Murakami M; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Sugita K; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Yano K; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Onishi S; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Kawano T; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Muto M; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan., Kaji T; Department of Pediatric Surgery, Kurume University of School of Medicine, Kurume, Japan., Ieiri S; Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan. sieiri@m.kufm.kagoshima-u.ac.jp. |
المصدر: | Pediatric surgery international [Pediatr Surg Int] 2024 Jul 16; Vol. 40 (1), pp. 190. Date of Electronic Publication: 2024 Jul 16. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 8609169 Publication Model: Electronic Cited Medium: Internet ISSN: 1437-9813 (Electronic) Linking ISSN: 01790358 NLM ISO Abbreviation: Pediatr Surg Int Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1986- |
مواضيع طبية MeSH: | Biliary Atresia*/surgery , Biliary Atresia*/complications , Cholangitis*/blood , Postoperative Complications* , Liver Transplantation*, Humans ; Male ; Female ; Infant ; Prognosis ; Retrospective Studies ; Child, Preschool ; Inflammation/blood ; Biomarkers/blood ; Living Donors |
مستخلص: | Purpose: Frequent post-operative cholangitis in biliary atresia (BA) affects the long-term native liver survival. This study assessed the characteristics of early cholangitis and their influence on the prognosis. Methods: Forty-three patients with BA who underwent surgery between 2000 and 2020 were analyzed for routine inflammatory markers. Early cholangitis characteristics were compared between native liver survivor (NLS) and living donor liver transplant (LDLT) patients. Results: Among the 43 patients, 30 (69.8%) experienced 130 episodes of cholangitis. In the area under the receiver operating characteristics curve (AUROC) analysis, the cutoff value of the total cholangitis episodes was 3, with an area under the AUROC curve of 0.695 (95% confidence interval 0.522-0.868). Before 3 years old, 113 episodes (86.9%) of cholangitis were observed. The white blood cell, C-reactive protein, and alanine aminotransferase values at cholangitis onset did not markedly differ between the LDLT and NLS groups. Conversely, the neutrophil-to-lymphocyte ratio in the NLS group was significantly lower than in the LDLT group (0.85 vs. 1.63, p < 0.001). Conclusions: Cholangitis in the NLS group was lymphocyte-dominant and atypical in its pathogenesis. Lymphocyte-dominant cholangitis is non-suppurative, and future research should clarify its pathogenesis to improve the treatment and prognosis of BA. (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
References: | Ernest van Heurn LW, Saing H, Tam PK (2003) Cholangitis after hepatic portoenterostomy for biliary atresia: a multivariate analysis of risk factors. J Pediatr 142(5):566–571. (PMID: 10.1067/mpd.2003.19512756392) Luo Y, Zheng S (2008) Current concept about postoperative cholangitis in biliary atresia. World J Pediatr 4(1):14–19. (PMID: 10.1007/s12519-008-0003-018402246) Wu ET, Chen HL, Ni YH, Lee PI, Hsu HY, Lai HS, Chang MH (2001) Bacterial cholangitis in patients with biliary atresia: impact on short-term outcome. Pediatr Surg Int 17(5–6):390–395. (PMID: 11527173) Nio M (2017) Japanese Biliary Atresia Registry. Pediatr Surg Int 33(12):1319–1325. (PMID: 10.1007/s00383-017-4160-x29039049) Venkat V, Ng VL, Magee JC, Ye W, Hawthorne K, Harpavat S, Molleston JP, Murray KF, Wang KS, Soufi N, Bass LM, Alonso EM, Bezerra JA, Jensen MK, Kamath BM, Loomes KM, Mack CL, Rosenthal P, Shneider BL, Squires RH, Sokol RJ, Karpen SJ, Childhood Liver Disease Research N (2020) Modeling outcomes in children with biliary atresia with native liver after 2 years of age. Hepatol Commun 4(12):1824–1834. (PMID: 10.1002/hep4.1602333051537706301) Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48(3):452–458. (PMID: 10.1038/bmt.2012.24423208313) Chen G, Liu J, Huang Y, Wu Y, Lu X, Dong R, Shen Z, Sun S, Jiang J, Zheng S (2021) Preventive effect of prophylactic intravenous antibiotics against cholangitis in biliary atresia: a randomized controlled trial. Pediatr Surg Int 37(8):1089–1097. (PMID: 10.1007/s00383-021-04916-z34013444) Madadi-Sanjani O, Schukfeh N, Uecker M, Eckmann S, Dingemann J, Ure BM, Petersen C, Kuebler JF (2021) The intestinal flora at kasai procedure in children with biliary atresia appears not to affect postoperative cholangitis. Eur J Pediatr Surg 31(1):80–85. (PMID: 10.1055/s-0040-171561432820494) Baek SH, Kang JM, Ihn K, Han SJ, Koh H, Ahn JG (2020) The epidemiology and etiology of cholangitis after kasai portoenterostomy in patients with biliary atresia. J Pediatr Gastroenterol Nutr 70(2):171–177. (PMID: 10.1097/MPG.000000000000255531978011) Cheng K, Molleston JP, Bennett WE Jr (2020) Cholangitis in patients with biliary atresia receiving hepatoportoenterostomy: a national database study. J Pediatr Gastroenterol Nutr 71(4):452–458. (PMID: 10.1097/MPG.000000000000283632639448) Houben C, Phelan S, Davenport M (2006) Late-presenting cholangitis and Roux loop obstruction after Kasai portoenterostomy for biliary atresia. J Pediatr Surg 41(6):1159–1164. (PMID: 10.1016/j.jpedsurg.2006.01.06616769353) Ecoffey C, Rothman E, Bernard O, Hadchouel M, Valayer J, Alagille D (1987) Bacterial cholangitis after surgery for biliary atresia. J Pediatr 111(6 Pt 1):824–829. (PMID: 10.1016/S0022-3476(87)80195-63681545) Muraji T, Tsugawa C, Nishijima E, Satoh S, Takamizawa S, Ise K, Maekawa T (2002) Surgical management for intractable cholangitis in biliary atresia. J Pediatr Surg 37(12):1713–1715. (PMID: 10.1053/jpsu.2002.3670312483638) Narayanaswamy B, Gonde C, Tredger JM, Hussain M, Vergani D, Davenport M (2007) Serial circulating markers of inflammation in biliary atresia–evolution of the post-operative inflammatory process. Hepatology 46(1):180–187. (PMID: 10.1002/hep.2170117596879) Hill R, Quaglia A, Hussain M, Hadzic N, Mieli-Vergani G, Vergani D, Davenport M (2015) Th-17 cells infiltrate the liver in human biliary atresia and are related to surgical outcome. J Pediatr Surg 50(8):1297–1303. (PMID: 10.1016/j.jpedsurg.2015.02.00525783388) Yang Y, Liu YJ, Tang ST, Yang L, Yang J, Cao GQ, Zhang JH, Wang XX, Mao YZ (2013) Elevated Th17 cells accompanied by decreased regulatory T cells and cytokine environment in infants with biliary atresia. Pediatr Surg Int 29(12):1249–1260. (PMID: 10.1007/s00383-013-3421-624122073) Harumatsu T, Muraji T, Sugita K, Murakami M, Yano K, Onishi S, Yamada K, Yamada W, Matsukubo M, Kawano T, Muto M, Kaji T, Ieiri S (2022) The preoperative lymphocyte ratio and postoperative C-reactive protein are related to the surgical outcome in biliary atresia: an analysis of serial ubiquitous markers of inflammation. Pediatr Surg Int 38(12):1777–1783. (PMID: 10.1007/s00383-022-05231-x36098795) Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102(6):653–657. (PMID: 10.1016/j.amjcard.2008.05.00618773982) Meng XY, Guo XG, Wang HQ, Pan ZY, Lu YG, Yu WF (2020) Baseline neutrophil-lymphocyte ratio is associated with survival for infant living donor liver transplantation for biliary atresia. Pediatr Transplant e13933. Lorente D, Mateo J, Templeton AJ, Zafeiriou Z, Bianchini D, Ferraldeschi R, Bahl A, Shen L, Su Z, Sartor O, de Bono JS (2015) Baseline neutrophil-lymphocyte ratio (NLR) is associated with survival and response to treatment with second-line chemotherapy for advanced prostate cancer independent of baseline steroid use. Ann Oncol 26(4):750–755. (PMID: 10.1093/annonc/mdu58725538172) Rothenberg SS, Schroter GP, Karrer FM, Lilly JR (1989) Cholangitis after the Kasai operation for biliary atresia. J Pediatr Surg 24(8):729–732. (PMID: 10.1016/S0022-3468(89)80525-12769536) |
فهرسة مساهمة: | Keywords: Biliary atresia; C-reactive protein; Cholangitis; Kasai portoenterostomy; Native liver survival rate; Neutrophil–lymphocyte ratio |
المشرفين على المادة: | 0 (Biomarkers) |
تواريخ الأحداث: | Date Created: 20240716 Date Completed: 20240716 Latest Revision: 20240716 |
رمز التحديث: | 20240716 |
DOI: | 10.1007/s00383-024-05774-1 |
PMID: | 39012391 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1437-9813 |
---|---|
DOI: | 10.1007/s00383-024-05774-1 |