Development and Post-Kasai Procedure Prognostic Relevance of Histological Features for Biliary Atresia

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2023 Nov 23

PMID 37993876

Authors

Xiaodan Xu

Xueting Wang

Meiyun Ding

Yilin Zhao

Li Zhao

Linsheng Zhao

Mengdi Li

Fangyuan Zhao

Rongjuan Sun

Zhiru Wang

Ruifeng Zhang

Shujian Zhang

Liang Ge

Yan Sun

Jianghua Zhan

Affiliations

Soon will be listed here.

Abstract

Objectives: To validate an appropriate evaluation method of liver fibrosis assessment based on the unique pathological features of biliary atresia (BA) that could well predict its prognosis.

Methods: A total of 68 patients with BA who underwent Kasai procedure (KP) and an intraoperative liver biopsy, followed up from January 2019 to December 2021, were recruited in a retrospective analysis. Ishak, Metavir, and BA-specific staging systems in relation to outcomes were analyzed using logistic regression, COX proportional hazard regression, Kaplan-Meier analysis, etc. RESULTS: Kaplan-Meier analysis determined a significant difference in native liver survival according to the BA-specific stage (p = 0.002). The ROC curve analysis for predicting prognosis showed that the AUC of BA-specific staging combined with iBALF and severe bile duct proliferation (BDP) (0.811, 95% CI: 0.710-0.913, p < 0.0001) was higher than BA-specific staging alone (0.755, 95% CI: 0.639-0.872, p < 0.001).

Conclusions: The BA-specific staging system reflects the condition of the liver fibrosis, and its combination with iBALF and severe BDP helps to better evaluate the prognosis of patients with BA.

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