دورية أكاديمية
Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study.
| العنوان: | Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study. |
|---|---|
| المؤلفون: | Chung PHY; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Harumatsu T; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Nakagawa Y; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Tsuboi K; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Chan EKW; Division of Pediatric Surgery and Pediatric Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Leung MWY; Department of Surgery, Hong Kong Children's Hospital, Hong Kong, HKSAR, People's Republic of China., Yeung F; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China., Muto M; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Kawano T; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Amano H; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Shirota C; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Nakamura H; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Koga H; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Miyano G; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Yamataka A; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Ieiri S; Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan., Uchida H; Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Wong KKY; Division of Paediatric Surgery, Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, HKSAR, People's Republic of China. kkywong@hku.hk. |
| المصدر: | Pediatric surgery international [Pediatr Surg Int] 2024 Jul 17; Vol. 40 (1), pp. 196. Date of Electronic Publication: 2024 Jul 17. |
| نوع المنشور: | Journal Article; Multicenter Study |
| 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 , Portoenterostomy, Hepatic*/methods , Hypertension, Portal*/etiology , Cholestasis*/etiology, Humans ; Male ; Female ; Infant ; Postoperative Complications/epidemiology ; Prospective Studies ; Follow-Up Studies ; Survivors/statistics & numerical data ; Infant, Newborn ; Child, Preschool |
| مستخلص: | Purpose: This study evaluated portal hypertension (PHT) and its predictors among native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE). Methods: This was a multicenter study using prospectively collected data. The subjects were patients who remained transplant-free for 5 years after KPE. Their status of PHT was evaluated and variables that predicted PHT were determined by regression analysis and receiver operating characteristic (ROC) curve. Results: Six centers from East Asia participated in this study and 320 subjects with KPE between 1980 to 2018 were analyzed. The mean follow-up period was 10.6 ± 6.2 years. At the 5th year after KPE, PHT was found in 37.8% of the subjects (n = 121). Patients with KPE done before day 41 of life had the lowest percentage of PHT compared to operation at older age. At 12 months after KPE, PHT + ve subjects had a higher bilirubin level (27.1 ± 11.7 vs 12.3 ± 7.9 µmol/L, p = 0.000) and persistent jaundice conferred a higher risk for PHT (OR = 12.9 [9.2-15.4], p = 0.000). ROC analysis demonstrated that a bilirubin level above 38 µmol/L at 12 months after KPE predicted PHT development (sensitivity: 78%, specificity: 60%, AUROC: 0.75). Conclusions: In BA, early KPE protects against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE are at a higher risk of this complication. They should receive a more vigilant follow-up. Level of Evidence: Level III. (© 2024. The Author(s).) |
| References: | Lykavieris P, Chardot C, Sokhn M, Gauthier F, Valayer J, Bernard O (2005) Outcome in adulthood of biliary atresia: a study of 63 patients who survived for over 20 years with their native liver. Hepatology 41(2):366–371. (PMID: 10.1002/hep.2054715660386) Jain V, Burford C, Alexander EC, Sutton H, Dhawan A, Joshi D et al (2019) Prognostic markers at adolescence in patients requiring liver transplantation for biliary atresia in adulthood. J Hepatol 71(1):71–77. (PMID: 10.1016/j.jhep.2019.03.00530876944) de Ledinghen V, Le Bail B, Rebouissoux L, Fournier C, Foucher J, Miette V et al (2007) Liver stiffness measurement in children using fibroscan: feasibility study and comparison with fibrotest, aspartate transaminase to platelets ratio index, and liver biopsy. J Pediatr Gastroenterol Nutr 45(4):443–450. (PMID: 10.1097/MPG.0b013e31812e56ff18030211) Shneider BL, Abel B, Haber B, Karpen SJ, Magee JC, Romero R et al (2012) Portal hypertension in children and young adults with biliary atresia. J Pediatr Gastroenterol Nutr 55(5):567–573. (PMID: 10.1097/MPG.0b013e31826eb0cf229030063483444) Tam PKH, Chung PHY, St Peter SD, Gayer CP, Ford HR, Tam GCH et al (2017) Advances in paediatric gastroenterology. Lancet 390(10099):1072–1082. (PMID: 10.1016/S0140-6736(17)32284-528901937) Araten DJ, Iori AP, Brown K, Torelli GF, Barberi W, Natalino F et al (2014) Selective splenic artery embolization for the treatment of thrombocytopenia and hypersplenism in paroxysmal nocturnal hemoglobinuria. J Hematol Oncol 7:27. (PMID: 10.1186/1756-8722-7-27246738263984395) Watanabe S, Suzuki T, Tsuchiya T, Kondo Y (2022) Long-term results of splenomegaly after surgery for biliary atresia in the native liver. Asian J Surg 45(3):849–853. (PMID: 10.1016/j.asjsur.2021.07.05634848145) D’Antiga L (2012) Medical management of esophageal varices and portal hypertension in children. Semin Pediatr Surg 21(3):211–218. (PMID: 10.1053/j.sempedsurg.2012.05.00422800974) Goldschmidt I, Brauch C, Poynard T, Baumann U (2014) Spleen stiffness measurement by transient elastography to diagnose portal hypertension in children. J Pediatr Gastroenterol Nutr 59(2):197–203. (PMID: 10.1097/MPG.000000000000040024732027) Sutton H, Fitzpatrick E, Davenport M, Burford C, Alexander E, Dhawan A et al (2018) Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. J Pediatr Gastroenterol Nutr 67(4):446–451. (PMID: 10.1097/MPG.000000000000206930234702) Gana JC, Turner D, Mieli-Vergani G, Davenport M, Miloh T, Avitzur Y et al (2011) A clinical prediction rule and platelet count predict esophageal varices in children. Gastroenterology 141(6):2009–2016. (PMID: 10.1053/j.gastro.2011.08.04921925123) Nio M, Wada M, Sasaki H, Tanaka H (2015) Effects of age at Kasai portoenterostomy on the surgical outcome: a review of the literature. Surg Today 45(7):813–818. (PMID: 10.1007/s00595-014-1024-z25212566) Chung PHY, Chan EKW, Yeung F, Chan ACY, Mou JWC, Lee KH et al (2021) Life long follow up and management strategies of patients living with native livers after Kasai portoenterostomy. Sci Rep 11(1):11207. (PMID: 10.1038/s41598-021-90860-w340456348160257) Lishuang M, Zhen C, Guoliang Q, Zhen Z, Chen W, Long L et al (2015) Laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia: a systematic review and meta-analysis of comparative studies. Pediatr Surg Int 31(3):261–269. (PMID: 10.1007/s00383-015-3662-725627699) Hussain MH, Alizai N, Patel B (2017) Outcomes of laparoscopic Kasai portoenterostomy for biliary atresia: a systematic review. J Pediatr Surg 52(2):264–267. (PMID: 10.1016/j.jpedsurg.2016.11.02228007417) Hinojosa-Gonzalez DE, Bueno LC, Roblesgil-Medrano A, Salgado-Garza G, Hurtado-Arellano S, Farias JS et al (2021) Laparoscopic vs open portoenterostomy in biliary atresia: a systematic review and meta-analysis. Pediatr Surg Int 37(11):1477–1487. (PMID: 10.1007/s00383-021-04964-534269866) Chen Y, Nah SA, Chiang L, Krishnaswamy G, Low Y (2015) Postoperative steroid therapy for biliary atresia: systematic review and meta-analysis. J Pediatr Surg 50(9):1590–1594. (PMID: 10.1016/j.jpedsurg.2015.05.01626143225) Carrion AF, Lindor KD, Levy C (2021) Safety of fibrates in cholestatic liver diseases. Liver Int 41(6):1335–1343. (PMID: 10.1111/liv.1487133751787) Mendes FD, Suzuki A, Sanderson SO, Lindor KD, Angulo P (2012) Prevalence and indicators of portal hypertension in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 10(9):1028–33.e2. (PMID: 10.1016/j.cgh.2012.05.008226100023424335) |
| فهرسة مساهمة: | Keywords: Biliary atresia; Cholestasis; Hypersplenism; Kasai portoenterostomy; Portal hypertension |
| تواريخ الأحداث: | Date Created: 20240717 Date Completed: 20240717 Latest Revision: 20240717 |
| رمز التحديث: | 20240718 |
| DOI: | 10.1007/s00383-024-05775-0 |
| PMID: | 39017953 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1437-9813 |
|---|---|
| DOI: | 10.1007/s00383-024-05775-0 |