Quantitative Liver Fibrosis Using Collagen Hybridizing Peptide to Predict Native Liver Survival in Biliary Atresia: A Pilot Study
| Autor: | Amy Lowichik, Catalina Jaramillo, Stephen L. Guthery, Yang Li, Taegun Kim, Michael Kyle Jensen, Gregory J. Stoddard |
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| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Bilirubin Biopsy medicine.medical_treatment Pilot Projects Liver transplantation Risk Assessment Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Liver Function Tests Cholestasis Biliary Atresia Predictive Value of Tests Biliary atresia Fibrosis 030225 pediatrics Internal medicine medicine Humans Proportional Hazards Models Retrospective Studies medicine.diagnostic_test business.industry Patient Selection Hazard ratio Infant Reproducibility of Results Prognosis medicine.disease Liver Transplantation Liver chemistry Liver biopsy Pediatrics Perinatology and Child Health Feasibility Studies Female 030211 gastroenterology & hepatology Collagen Peptides business |
| Zdroj: | Journal of Pediatric Gastroenterology & Nutrition. 70:87-92 |
| ISSN: | 1536-4801 0277-2116 |
| Popis: | Background/rationale Biliary atresia (BA) is a cholangiopathy characterized by bile flow obstruction due to destruction of the biliary tree. Without surgical correction with Kasai portoenterostomy (KPE), BA leads to death or liver transplant (LTx). Early-onset, progressive liver fibrosis is a defining characteristic of BA. Collagen hybridizing peptide (CHP) is a synthetic peptide which binds to denatured collagen strands allowing quantification of fibrosis. This technique has not been used on human liver tissue. The aim of this pilot study was to evaluate the utility of CHP as a measurement of quantitative fibrosis to allow earlier survival with native liver prognostication. Results We identified 21 patients with wedge liver biopsies available, of which 14 required LTx. No deaths occurred. Patients requiring LTx tended to be girls with a significantly different mean bilirubin (P = 0.002), albumin (P = 0.001), and alanine aminotransferase (P = 0.03) at 3 months post-KPE. By 1 year post-KPE, 50% of patients in the high CHP intensity group required LTx versus 27% in the low CHP. Overall, fibrosis as quantified by CHP at time of KPE was associated with more than 3 times the risk of requiring LTx by 4 years of age (hazard ratio 3.6, 95% confidence interval 1.15-10.93, P = 0.03). When controlling for sex and total bilirubin >2 mg/dL and albumin at 3 months post-KPE, it predicted nearly 7 times the risk of LTx (hazard ratio 6.89, 95% confidence interval 1.38-34.32, P = 0.02). Conclusion Our results suggest that quantitative assessment of fibrosis at the time of KPE holds promise as an earlier predictor of LTx requirement in BA. A larger study is justified to assess quantitative fibrosis as a BA prognostic tool. |
| Databáze: | OpenAIRE |
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