Publication:
Prognostic values of serum bilirubin at 7th day post-Kasai for survival with native livers in patients with biliary atresia

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Issued Date

2016

Resource Type

Article

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application/pdf

ISSN

1790358

DOI

10.1007/s00383-016-3951-9

Other identifier(s)

2-s2.0-84980010311

Rights Holder(s)

Scopus

Bibliographic Citation

Pediatric Surgery International. Vol 32, No.10 (2016), p.927-931

Suggested Citation

Chusilp S., Sookpotarom P., Tepmalai K., Rajatapiti P., Chongsrisawat V., Poovorawan Y., Vejchapipat P. Prognostic values of serum bilirubin at 7th day post-Kasai for survival with native livers in patients with biliary atresia. Pediatric Surgery International. Vol 32, No.10 (2016), p.927-931. doi:10.1007/s00383-016-3951-9 Retrieved from: https://hdl.handle.net/20.500.14740/5141

Title

Prognostic values of serum bilirubin at 7th day post-Kasai for survival with native livers in patients with biliary atresia

Author(s)

Chusilp S.
 Sookpotarom P.
 Tepmalai K.
 Rajatapiti P.
 Chongsrisawat V.
 Poovorawan Y.
 Vejchapipat P.

Abstract

Background: Biliary atresia (BA) is a serious liver disease with uncertain prognosis. The objective of this study was to investigate prognostic values of the >20 % decrease in serum total bilirubin (TB) at 7th day post-op regarding early outcome and 5-year survival with native liver in BA. Methods: Biliary atresia patients undergoing Kasai operation between 2000 and 2014 were reviewed. The ratio of serum TB at 7th day post-op to pre-op TB levels (TB7/TB0) was calculated for every patient. TB7/TB0 ratio of <0.8 indicated the >20 % decrease in serum TB. At 6th month following Kasai operation, outcome of BA patients were categorized into good outcome (TB < 2 mg % or clinically jaundice free) and poor outcome (TB > 2 mg % or clinically jaundice). For outcome analysis, logistic regression was used. For survival analysis, Cox regression was applied. Results: There were 133 BA patients (M:F = 68:65) undergoing Kasai operation. Median age at surgery was 79 days. BA patients with TB7/TB0 ratio of <0.8 were found in 38 %. Outcome at 6-month post-op could be evaluated in 126 patients (good: poor = 68:58). The 1-, 3- and 5-year survival rates with native livers were 85, 70 and 65 %, respectively. The median overall survival with native livers was 164 months. Median follow-up time was 87 months. Logistic regression showed that gender and age at operation were not significant factors impacting on early outcome (p > 0.05). However, TB7/TB0 ratio of <0.8 was an independent factor for good outcome (Odds ratio = 3.0, p = 0.006). Cox regression analysis demonstrated that 5-year survival rate was significantly correlated with TB7/TB0 ratio of <0.8 (HR = 0.46, 95 % CI 0.23–0.91, p = 0.025) and outcome at 6th month post-op (HR = 0.05, 95 % CI 0.01–0.15, p < 0.001). Conclusions: The >20 % decrease in serum TB at 7th day post-Kasai is a predictor for good outcome. BA patients with TB7/TB0 of <0.8 had 5-year survival with native livers significantly higher than those with the ratio of >0.8. © 2016, Springer-Verlag Berlin Heidelberg.

Subject(s)

Bilirubin
 Bilirubin
 Article
 Bile duct atresia
 Bilirubin blood level
 Female
 Follow up
 Human
 Infant
 Jaundice
 Logistic regression analysis
 Major clinical study
 Male
 Newborn
 Outcome assessment
 Overall survival
 Portoenterostomy
 Postoperative period
 Predictive value
 Preoperative period
 Priority journal
 Prognosis
 Proportional hazards model
 Survival
 Survival analysis
 Survival rate
 Survival time
 Biliary Atresia
 Blood
 Liver
 Mortality
 Odds ratio
 Portoenterostomy
 Postoperative complication
 Prognosis
 Treatment outcome
 Biliary Atresia
 Bilirubin
 Female
 Humans
 Infant
 Infant, Newborn
 Liver
 Male
 Odds Ratio
 Portoenterostomy, Hepatic
 Postoperative Complications
 Postoperative Period
 Prognosis
 Survival Analysis
 Survival Rate
 Treatment Outcome

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https://hdl.handle.net/20.500.14740/5141

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Scopus: Year 1983-2021

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