Kyong Ihn1, In Geol Ho2, Eun Young Chang3, Seok Joo Han4. 1. Department of Pediatric Surgery, Severance Children's Hospital, Department of Surgery, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Electronic address: kihn81@gmail.com. 2. Department of Pediatric Surgery, Severance Children's Hospital, Department of Surgery, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Electronic address: HNJKLOP@yuhs.ac. 3. Department of Pediatric Surgery, Severance Children's Hospital, Department of Surgery, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Electronic address: sophie4174@hanmail.net. 4. Department of Pediatric Surgery, Severance Children's Hospital, Department of Surgery, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Electronic address: sjhan@yuhs.ac.
Abstract
BACKGROUND/ PURPOSE: The role of serum gamma-glutamyl transpeptidase (GGT) levels in predicting clinical outcomes after Kasai portoenterostomy (KPE) is unknown. This study analyzed whether postoperative GGT along with the aspartate aminotransferase-to-platelet ratio index (APRi) predicted prognosis of biliary atresia (BA). METHODS: Data were retrospectively reviewed for 169 BA patients categorized into jaundice-free (JF) (total bilirubin <2.0 mg/dL ≤6 months post-KPE) and persistent jaundice (PJ) groups (total bilirubin ≥2.0 mg/dL ≤6 months post-KPE). Serum biochemical markers, including GGT levels, were measured monthly after KPE, and mean GGT levels and APRi were compared between groups. Factors predicting native liver survival (NLS) were determined using a Cox regression analysis. RESULTS: GGT concentrations >550 IU/L at month 5 (hazard ratio: 1.74, P < 0.05), an APRi >0.605 at month 4 (hazard ratio: 3.78, P = 0.001), and being jaundice-free at 6 months (hazard ratio: 5.49, P < 0.001) were independent risk factors for decreased NLS. CONCLUSIONS: Serum GGT concentrations >550 IU/L at month 5 and an APRi >0.605 at month 4 post-KPE were associated with significantly lower NLS rates. Among JF patients, those with GGT concentrations >550 IU/L at month 5 and APRi >0.605 at month 4 showed poorer outcomes. TYPE OF STUDY: Retrospective comparative study LEVEL OF EVIDENCE: Level III.
BACKGROUND/ PURPOSE: The role of serum gamma-glutamyl transpeptidase (GGT) levels in predicting clinical outcomes after Kasai portoenterostomy (KPE) is unknown. This study analyzed whether postoperative GGT along with the aspartate aminotransferase-to-platelet ratio index (APRi) predicted prognosis of biliary atresia (BA). METHODS: Data were retrospectively reviewed for 169 BA patients categorized into jaundice-free (JF) (total bilirubin <2.0 mg/dL ≤6 months post-KPE) and persistent jaundice (PJ) groups (total bilirubin ≥2.0 mg/dL ≤6 months post-KPE). Serum biochemical markers, including GGT levels, were measured monthly after KPE, and mean GGT levels and APRi were compared between groups. Factors predicting native liver survival (NLS) were determined using a Cox regression analysis. RESULTS:GGT concentrations >550 IU/L at month 5 (hazard ratio: 1.74, P < 0.05), an APRi >0.605 at month 4 (hazard ratio: 3.78, P = 0.001), and being jaundice-free at 6 months (hazard ratio: 5.49, P < 0.001) were independent risk factors for decreased NLS. CONCLUSIONS: Serum GGT concentrations >550 IU/L at month 5 and an APRi >0.605 at month 4 post-KPE were associated with significantly lower NLS rates. Among JF patients, those with GGT concentrations >550 IU/L at month 5 and APRi >0.605 at month 4 showed poorer outcomes. TYPE OF STUDY: Retrospective comparative study LEVEL OF EVIDENCE: Level III.
Authors: Veena Venkat; Vicky L Ng; John C Magee; Wen Ye; Kieran Hawthorne; Sanjiv Harpavat; Jean P Molleston; Karen F Murray; Kasper S Wang; Nisreen Soufi; Lee M Bass; Estella M Alonso; Jorge A Bezerra; M Kyle Jensen; Binita M Kamath; Kathleen M Loomes; Cara L Mack; Philip Rosenthal; Benjamin L Shneider; Robert H Squires; Ronald J Sokol; Saul J Karpen Journal: Hepatol Commun Date: 2020-10-03
Authors: Lin He; Dennis Kai Ming Ip; Greta Tam; Vincent Chi Hang Lui; Paul Kwong Hang Tam; Patrick Ho Yu Chung Journal: Sci Rep Date: 2021-06-03 Impact factor: 4.379