Long-term Results and Quality of Life Assessment in Biliary Atresia Patients: A 35-Year Experience in a Tertiary Hospital
| Autor: | Carol Wing Yan Wong, Paul K.H. Tam, Kenneth K. Y. Wong, Patrick Ho Yu Chung |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Portoenterostomy Hepatic Tertiary Care Centers Young Adult 03 medical and health sciences 0302 clinical medicine Quality of life Biliary Atresia Biliary atresia Prevalence medicine Humans 030212 general & internal medicine Child Retrospective Studies business.industry Gastroenterology Infant Retrospective cohort study Long term results medicine.disease Survival Analysis humanities Liver Transplantation Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Quality of Life Female 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Pediatric Gastroenterology & Nutrition. 66:570-574 |
| ISSN: | 1536-4801 0277-2116 |
| Popis: | To review long-term transplant-free survival and quality of life (QOL) of patients with biliary atresia (BA).A retrospective study reviewing all patients with Kasai operation between January 1, 1980 and December 31, 2015 was performed to evaluate the transplant-free survival. Subgroup analysis of patients older than 20 years was carried out to assess the QOL using the Short Form-36 Health Survey and incidences of disease-related complications. Comparison between patients with native and transplanted liver was performed using two-tailed independent samples t-test (P value 0.05, significant).The 20-year Kaplan-Meier transplant-free survival of the 141 patients in our study was 51%. The subgroup analysis of long-term survivors revealed a trend of increased prevalence of complications like esophageal varices, portal hypertension, and recurrent admissions in the patient groups with raised serum bilirubin (SB).Thirty-one patients were successfully contacted for QOL assessment, 26 (16 with native liver and 10 with transplanted liver) responded (76.5%). BA patients who were documented to have active complications have a significantly lower vitality score (50.7 vs 57.5, P = 0.015). There was no statistically significant difference in the scores between the transplanted group and the disease-free control group. However, the native liver group achieved a lower score in both the general health section (42.9 vs 49.6, P = 0.029) and the overall physical component (49.6 vs 54.4, P = 0.037).A significant proportion of our patients survive with their native liver for more than 20 years. These long-term survivors may suffer from complications that impair their QOL. They require continuous life-long care. |
| Databáze: | OpenAIRE |
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