Predictors of Successful Kasai Portoenterostomy and Survival with Native Liver at 2 Years in Infants with Biliary Atresia.

Autor: Kumar R; Department of Pediatric Hepatology, New Delhi, India., Lal BB; Department of Pediatric Hepatology, New Delhi, India., Sood V; Department of Pediatric Hepatology, New Delhi, India., Khanna R; Department of Pediatric Hepatology, New Delhi, India., Kumar S; Department of HPB Surgery, Institute of Liver and Biliary Sciences, New Delhi, India., Bharathy KGS; Department of HPB Surgery, Institute of Liver and Biliary Sciences, New Delhi, India., Alam S; Department of Pediatric Hepatology, New Delhi, India.
Jazyk: angličtina
Zdroj: Journal of clinical and experimental hepatology [J Clin Exp Hepatol] 2019 Jul-Aug; Vol. 9 (4), pp. 453-459. Date of Electronic Publication: 2018 Oct 05.
DOI: 10.1016/j.jceh.2018.09.008
Abstrakt: Objectives: Kasai portoenterostomy (KPE) is the primary treatment for biliary atresia (BA) with subsequent liver transplantation in failed cases. The aim of this work was to study the outcome of KPE in children with BA and identify the factors predicting a successful KPE.
Methods: Children diagnosed with BA and undergoing KPE between January 2010 and January 2018 were included in the study. A successful KPE was defined as decrease in bilirubin to less than 2 mg/dL at 6 months after KPE. Factors affecting the outcome (successful KPE and survival with native liver [SNL] at 2 years) were evaluated by logistic regression.
Results: A total of 79 children with post-KPE BA were included. Successful KPE was achieved in 29 (36.7%) of 79 children undergoing KPE. The data for survival with native liver at 2 years were available for 61 children as 9 were lost to follow up before 2 years and another 9 were aged less than 2 years at the time of analysis. Twenty-seven (44.3%) of these 61 survived with their native liver at 2 years. On logistic regression analysis, lower age at KPE, use of postoperative steroids and absence of cholangitis were significant predictors of a successful KPE. A successful KPE at 6 months was the lone independent predictor of SNL at 2 years in these children.
Conclusion: Early age at KPE, use of postoperative steroid and prevention of cholangitis can result in successful KPE. Those with successful KPE are likely to survive with their native liver at 2 years.
Databáze: MEDLINE
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