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BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Number of cholangitis episodes as a prognostic marker to predict timing of liver transplantation in biliary atresia patients after Kasai portoenterostomy

Authors: Szu-Ying Chen, Chieh-Chung Lin, Yu-Tse Tsan, Wei-Cheng Chan, Jiaan-Der Wang, Yi-Jung Chou, Ching-Heng Lin

Published in: BMC Pediatrics | Issue 1/2018

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Abstract

Background

Cholangitis may affect liver failure of biliary atresia (BA) patients after Kasai portoenterostomy (KP). We examined whether the number of cholangitis episodes could be a prognostic marker for liver transplant (LT) in children with BA after Kasai portoenterostomy (KP).

Methods

Data for BA patients born after 1998 and undergoing KP were obtained from National Health Insurance Research Database (NHIRD), Taiwan. Patients were followed up until the end of 2011. Incidence and the number of cholangitis episodes were recorded and compared between patients based on LT status.

Results

Ninety-six (26.8%) of the 366 BA patients underwent LT. More patients who underwent KP at < 60 days of age survived with their native liver (P = 0.007). The mean age at first cholangitis was 0.9 years and 0.8 years in the LT and non-LT groups, respectively (P = 0.868). The cumulative incidence of cholangitis within 2 years after KP did not differ between the groups (hazard ratio 1.2; 95% CI 0.9–1.6). However, the total number of cholangitis episodes was higher in the LT group within 2 years after KP (P < 0.001).

Conclusions

Cholangitis occurrence was not related to LT in the first 2 years after KP in BA patients, but the number of cholangitis episodes could be a prognostic marker for future LT.
Literature
1.
Chardot C, Carton M, Spire-Bendelac N, et al. Epidemiology of biliary atresia in France: a national study 1986-96. J Hepatol. 1999;31:1006–13.CrossRefPubMed
2.
McKiernan PJ, Baker AJ, Kelly DA. The frequency and outcome of biliary atresia in the UK and Ireland. Lancet. 2000;355:25–9.CrossRefPubMed
3.
Schreiber RA, Barker CC, Roberts EA, et al. Biliary atresia in Canada: the effect of centre caseload experience on outcome. J Pediatr Gastroenterol Nutr. 2010;51:61–5.CrossRefPubMed
4.
Nio M, Ohi R, Hayashi Y, et al. Current status of 21 patients who have survived more than 20 years since undergoing surgery for biliary atresia. J Pediatr Surg. 1996;31:381–4.CrossRefPubMed
5.
Chardot C, Carton M, Spire-Bendelac N, et al. Prognosis of biliary atresia in the era of liver transplantation: French national study from 1986 to 1996. Hepatology. 1999;30:606–11.CrossRefPubMed
6.
Ohi R, Nio M, Chiba T, et al. Long-term follow-up after surgery for patients with biliary atresia. J Pediatr Surg. 1990;25:442–5.CrossRefPubMed
7.
Hsiao CH, Chang MH, Chen HL, et al. Universal screening for biliary atresia using an infant stool color card in Taiwan. Hepatology. 2008;47:1233–40.CrossRefPubMed
8.
Chen SM, Chang MH, Du JC, et al. Screening for biliary atresia by infant stool color card in Taiwan. Pediatrics. 2006;117:1147–54.CrossRefPubMed
9.
Nio M, Ohi R, Miyano T, et al. Five- and 10-year survival rates after surgery for biliary atresia: a report from the Japanese biliary atresia registry. J Pediatr Surg. 2003;38:997–1000.CrossRefPubMed
10.
Shneider BL, Mazariegos GV. Biliary atresia: a transplant perspective. Liver Transpl. 2007;13:1482–95.CrossRefPubMed
11.
Arnon R, Annunziato RA, D'Amelio G, et al. Liver transplantation for biliary atresia: is there a difference in outcome for infants? J Pediatr Gastroenterol Nutr. 2016;62(2):220–5.CrossRefPubMed
12.
Gottrand F, Bernard O, Hadchouel M, et al. Late cholangitis after successful surgical repair of biliary atresia. Am J Dis Child. 1991;145:213–5.PubMed
13.
Ernest van Heurn LW, Saing H, Tam PK. Cholangitis after hepatic portoenterostomy for biliary atresia: a multivariate analysis of risk factors. J Pediatr. 2003;142:566–71.CrossRefPubMed
14.
Nio M, Sano N, Ishii T, et al. Cholangitis as a late complication in long-term survivors after surgery for biliary atresia. J Pediatr Surg. 2004;39:1797–9.CrossRefPubMed
15.
Nio M, Wada M, Sasaki H, et al. Risk factors affecting late-presenting liver failure in adult patients with biliary atresia. J Pediatr Surg. 2012;47:2179–83.CrossRefPubMed
16.
Koga H, Wada M, Nakamura H, et al. Factors influencing jaundice-free survival with the native liver in post-portoenterostomy biliary atresia patients: results from a single institution. J Pediatr Surg. 2013;48:2368–72.CrossRefPubMed
17.
Cheng CL, Kao YH, Lin SJ, et al. Validation of the National Health Insurance Research Database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf. 2011;20:236–42.CrossRefPubMed
18.
Cheng CL, Lee CH, Chen PS, et al. Validation of acute myocardial infarction cases in the national health insurance research database in taiwan. J Epidemiol. 2014;24:500–7.CrossRefPubMedPubMedCentral
19.
Hung PY, Chen CC, Chen WJ, et al. Long-term prognosis of patients with biliary atresia: a 25 year summary. J Pediatr Gastroenterol Nutr. 2006;42:190–5.CrossRefPubMed
20.
Shinkai M, Ohhama Y, Take H, et al. Long-term outcome of children with biliary atresia who were not transplanted after the Kasai operation: >20-year experience at a children&apos;s hospital. J Pediatr Gastroenterol Nutr. 2009;48:443–50.CrossRefPubMed
21.
Lykavieris P, Chardot C, Sokhn M, et al. Outcome in adulthood of biliary atresia: a study of 63 patients who survived for over 20 years with their native liver. Hepatology. 2005;41:366–71.CrossRefPubMed
22.
de Vries W, Homan-van der Veen J, Hulscher JB, et al. Twenty-year transplant-free survival rate among patients with biliary atresia. Clin Gastroenterol Hepatol. 2011;9:1086–91.CrossRefPubMed
23.
Yanchar NL, Shapiro AM, Sigalet DL. Is early response to portoenterostomy predictive of long-term outcome for patients with biliary atresia? J Pediatr Surg. 1996;31:774–8.CrossRefPubMed
24.
Kasai M, Kimura S, Asakura Y, et al. Surgical treatment of biliary atresia. J Pediatr Surg. 1968;3:665–75.CrossRef
25.
Oh M, Hobeldin M, Chen T, et al. The Kasai procedure in the treatment of biliary atresia. J Pediatr Surg. 1995;30:1077–80.CrossRefPubMed
26.
Ng VL, Haber BH, Magee JC, et al. Medical status of 219 children with biliary atresia surviving long-term with their native livers: results from a north american multicenter consortium. J Pediatr. 2014;165:539–46.CrossRefPubMedPubMedCentral
27.
Wu ET, Chen HL, Ni YH, et al. Bacterial cholangitis in patients with biliary atresia: impact on short-term outcome. Pediatr Surg Int. 2001;17:390–5.CrossRefPubMed
28.
Ecoffey C, Rothman E, Bernard O, et al. Bacterial cholangitis after surgery for biliary atresia. J Pediatr. 1987;111:824–9.CrossRefPubMed
29.
Suzuki T, Hashimoto T, Kondo S, et al. Evaluating patients&apos; outcome post-Kasai operation: a 19-year experience with modification of the hepatic portoenterostomy and applying a novel steroid therapy regimen. Pediatr Surg Int. 2010;26:825–30.CrossRefPubMed
30.
Wildhaber BE, Coran AG, Drongowski RA, et al. The Kasai portoenterostomy for biliary atresia: a review of a 27-year experience with 81 patients. J Pediatr Surg. 2003;38:1480–5.CrossRefPubMed
31.
Rothenberg SS, Schroter GP, Karrer FM, et al. Cholangitis after the Kasai operation for biliary atresia. J Pediatr Surg. 1989;24:729–32.CrossRefPubMed
Metadata
Title
Number of cholangitis episodes as a prognostic marker to predict timing of liver transplantation in biliary atresia patients after Kasai portoenterostomy
Authors
Szu-Ying Chen
Chieh-Chung Lin
Yu-Tse Tsan
Wei-Cheng Chan
Jiaan-Der Wang
Yi-Jung Chou
Ching-Heng Lin
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1074-2

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