Histopathological findings for prediction of liver cirrhosis and survival in biliary atresia patients after Kasai procedure
Autor: | Dwiki Afandy, Aditya Rifqi Fauzi, Hanggoro Tri Rinonce, Fiko Ryantono, Dian Nirmala Sirait, Leila Rakhma Budiarti, Vincentia Meta Widya Paramita, Gunadi, Akhmad Makhmudi, Naomi Yoshuantari |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Pathology Histology Cirrhosis Portoenterostomy Hepatic Gastroenterology Kasai procedure Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Cholestasis Interquartile range Fibrosis Biliary atresia Biliary Atresia 030225 pediatrics Internal medicine lcsh:Pathology medicine Humans Retrospective Studies medicine.diagnostic_test business.industry Research Infant General Medicine medicine.disease Prognosis Bile duct proliferation Transplantation Liver biopsy Histopathological findings Patient survival 030211 gastroenterology & hepatology Female business lcsh:RB1-214 |
Zdroj: | Diagnostic Pathology Diagnostic Pathology, Vol 15, Iss 1, Pp 1-8 (2020) |
ISSN: | 1746-1596 |
Popis: | Background Without early recognition and Kasai procedure, biliary atresia (BA) results in liver cirrhosis and leads to either transplantation or death at a young age. We aimed to characterize the liver histopathological findings for prediction of cirrhosis and survival in BA patients after Kasai surgery. Methods We retrospectively reviewed all histopathological results for BA patients who underwent liver biopsy during Kasai surgery from August 2012 to December 2018 in Dr. Sardjito Hospital, Yogyakarta, Indonesia. Results Fifty infants with BA were ascertained in our study, of whom 27 were males and 23 were females. The median age of Kasai procedure was 102.5 days (interquartile range (IQR), 75.75–142.25 days). There were 33 (66%) and 17 (34%) BA patients with and without liver cirrhosis, respectively, while the overall survival was 52%. The patients with a severe bile duct proliferation, severe cholestasis, and severe portal inflammation have a higher risk by 27-, 22-, and 19.3-fold, respectively, to develop liver cirrhosis compared with patients with a moderate/mild bile duct proliferation, moderate/mild/without cholestasis, and moderate/mild portal inflammation, respectively (p = 3.6 × 10− 6, 5.6 × 10− 4, and 1.6 × 10− 3, respectively), while the giant cell transformation was not associate with the development of liver cirrhosis (p = 0.77). The bile duct proliferation was strongly correlated with cholestasis and portal inflammation (p = 7.3 × 10− 5 and 2 × 10− 4, respectively), and cholestasis was also significantly correlated with portal inflammation (p = 0.016). Interestingly, the age at Kasai procedure was strongly associated with the development of liver cirrhosis (p = 0.02), but not with the patients’ survival (p = 0.33), while the degree of fibrosis and cholestasis were significantly correlated with the patients’ survival, with HR of 3.9 (95% CI = 1.7–9.0; p = 0.017) and 3.1 (95% CI = 1.4–7.0; p = 0.016), respectively. Conclusions Histopathological findings of bile duct proliferation, cholestasis, and portal inflammation can predict the liver cirrhosis development in patients with BA. Furthermore, degree of fibrosis and cholestasis affect the patients’ survival following the Kasai operation. |
Databáze: | OpenAIRE |
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