Cho-Yi Huang1, Mei-Hwei Chang1, Huey-Ling Chen1, Yen-Hsuan Ni1,2, Hong-Yuan Hsu1, Jia-Feng Wu3. 1. Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 2. Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. 3. Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. wjf@ntu.edu.tw.
Abstract
BACKGROUND: To determine a very early predictive biomarker after hepatoportoenterostomy (HPE) for the prediction of native liver survival in biliary atresia (BA) patients. METHODS: A retrospective chart review was conducted of BA patients in our hospital between August 2000 and April 2019. The serum total bilirubin (T-bil), direct bilirubin, and gamma-glutamyl transferase level 1 week after HPE were analyzed. The clinical outcome predictors were investigated. RESULTS: A total of 90 BA patients were recruited. Receiver operating characteristic curve analysis showed that a post-HPE 1-week T-bil level ≤4.85 mg/dL predicted jaundice-free after HPE (P = 0.02). BA patients with a post-HPE 1-week T-bil ≤4.85 mg/dL were more likely to be jaundice-free within 3 months of HPE (odds ratio = 3.53; P = 0.006). Kaplan-Meier plot analysis showed that the likelihood of native liver survival and jaundice-free native liver survival were significantly higher in BA subjects with a post-HPE 1-week T-bil ≤4.85 mg/dL than in other subjects (P = 0.01 and 0.01, respectively). CONCLUSIONS: The serum post-HPE 1-week T-bil level may predict the long-term outcome in BA patients. A post-HPE 1-week T-bil ≤4.85 mg/dL correlated with better native liver survival and jaundice-free native liver survival in BA patients.
BACKGROUND: To determine a very early predictive biomarker after hepatoportoenterostomy (HPE) for the prediction of native liver survival in biliary atresia (BA) patients. METHODS: A retrospective chart review was conducted of BApatients in our hospital between August 2000 and April 2019. The serum total bilirubin (T-bil), direct bilirubin, and gamma-glutamyl transferase level 1 week after HPE were analyzed. The clinical outcome predictors were investigated. RESULTS: A total of 90 BApatients were recruited. Receiver operating characteristic curve analysis showed that a post-HPE 1-week T-bil level ≤4.85 mg/dL predicted jaundice-free after HPE (P = 0.02). BApatients with a post-HPE 1-week T-bil ≤4.85 mg/dL were more likely to be jaundice-free within 3 months of HPE (odds ratio = 3.53; P = 0.006). Kaplan-Meier plot analysis showed that the likelihood of native liver survival and jaundice-free native liver survival were significantly higher in BA subjects with a post-HPE 1-week T-bil ≤4.85 mg/dL than in other subjects (P = 0.01 and 0.01, respectively). CONCLUSIONS: The serum post-HPE 1-week T-bil level may predict the long-term outcome in BApatients. A post-HPE 1-week T-bil ≤4.85 mg/dL correlated with better native liver survival and jaundice-free native liver survival in BApatients.
Authors: Raluca-Cristina Apostu; Vlad Fagarasan; Catalin C Ciuce; Radu Drasovean; Dan Gheban; Radu Razvan Scurtu; Alina Grama; Ana Cristina Stefanescu; Constantin Ciuce; Tudor Lucian Pop Journal: Medicina (Kaunas) Date: 2020-12-28 Impact factor: 2.430