Clinical Benefit of Liver Stiffness Measurement at 3 Months after Kasai Hepatoportoenterostomy to Predict the Liver Related Events in Biliary Atresia
Open Access
- 18 November 2013
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 8 (11), e80652
- https://doi.org/10.1371/journal.pone.0080652
Abstract
The progression of hepatic fibrosis may result in decompensated hepatic failure with cirrhosis, liver related events (LRE) such as ascites, variceal bleeding, and death after successful and timely Kasai hepatoportoenterostomy (HPE) in biliary atresia. The aim of this study is to suggest clinical benefit of the liver stiffness measurement (LSM) using transient elastography at 3 months after the Kasai operation to predict LRE. Between January 2007 and December 2011, 69 eligible biliary atresia patients who underwent Kasai HPE and performed transient elastography before and 3 months after HPE were included. The occurrences of LRE were analyzed for all patients. All patients were divided into 2 groups (with and without LRE) for comparison. Multivariate analysis was used to detect the independent risk factors of LRE. The area under the receiver operation characteristics curve (AUROC) was used to establish the LSM optimal cutoff value of 3 months after Kasai operation in predicting LRE. LSM value, aminotransferase, albumin, bilirubin, and PT-INR significantly differed among the two groups. Multivariate analysis demonstrated LSM value as the most powerful independent factor of the development of LRE. The cut-off value of 19.9 kPa was calculated to be optimal for predicting LRE development with total sensitivity and specificity of 1.804. AUROC resulted in 0.943, with sensitivity of 85.3% and specificity of 95.2%. The LSM value of 3 months after Kasai HPE can be a useful predictor of LRE development.This publication has 29 references indexed in Scilit:
- The Anatomic Pattern of Biliary Atresia Identified at Time of Kasai Hepatoportoenterostomy and Early Postoperative Clearance of Jaundice Are Significant Predictors of Transplant-Free SurvivalAnnals of Surgery, 2011
- Assessment of Liver Fibrosis and Cirrhosis by Aspartate Aminotransferase‐to‐Platelet Ratio Index in Children With Biliary AtresiaJournal of Pediatric Gastroenterology and Nutrition, 2010
- Biliary atresiaThe Lancet, 2009
- Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis CHepatology, 2008
- Liver Stiffness Measurement in Children Using FibroScan: Feasibility Study and Comparison With Fibrotest, Aspartate Transaminase to Platelets Ratio Index, and Liver BiopsyJournal of Pediatric Gastroenterology and Nutrition, 2007
- Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosisHepatology, 2007
- A multicenter study of the outcome of biliary atresia in the United States, 1997 to 2000The Journal of Pediatrics, 2006
- Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis CGastroenterology, 2005
- Biliary atresia: an update on our understanding of the disorderCurrent Opinion in Pediatrics, 2001
- Acute variceal bleeding: general managementWorld Journal of Gastroenterology, 2001