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Assessment of liver fibrosis and cirrhosis by aspartate aminotransferase-to-platelet ratio index in children with biliary atresia

Authors
 Sang Yong Kim  ;  Jae Yeon Seok  ;  Seok Joo Han  ;  Hong Koh 
Citation
 JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, Vol.51(2) : 198-202, 2010 
Journal Title
 JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION 
ISSN
 0277-2116 
Issue Date
2010
MeSH
Area Under Curve ; Aspartate Aminotransferases/blood* ; Biliary Atresia/blood ; Biliary Atresia/complications* ; Biliary Atresia/surgery ; Blood Platelets/metabolism* ; Female ; Humans ; Infant ; Liver Cirrhosis/blood ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/etiology ; Male ; ROC Curve ; Reference Values
Keywords
aspartate aminotransferase-to-platelet ratio index ; biliary atresia ; cirrhosis ; liver fibrosis ; Metavir classification
Abstract
BACKGROUND: In patients with biliary atresia (BA), liver fibrosis and cirrhosis commonly occur even after Kasai hepatoportoenterostomy. Although liver biopsy is the gold standard to evaluate liver fibrosis, it is invasive and may result in life-threatening complications. The aspartate aminotransferase-to-platelet ratio index (APRI) is a safe and simple method to assess liver fibrosis in patients with chronic liver diseases. To use APRI as a postoperative follow-up tool, we validated the diagnostic power of APRI for the degree of liver fibrosis in postoperative patients with BA. PATIENTS AND METHODS: Patients with newly diagnosed BA who underwent the Kasai procedure between March 2006 and May 2009 were analyzed. Several laboratory tests including APRI were performed. Liver wedge biopsy specimens were obtained during the surgical procedure, and histopathologic analyses were performed using the Metavir classification. RESULTS: Thirty-five patients (12 boys, median age of 1.9 months) were enrolled. Metavir scores were F1 in 0, F2 in 11, F3 in 11, and F4 in 13 patients. The areas under the receiver operating characteristics curves for F > or = 3 and F = 4 were 0.92 and 0.91, respectively. Distinct optimal cutoff values of APRI for F > or = 3 and F = 4 were obtained (1.01 and 1.41, respectively). Clinical outcomes of patients were significantly different between 2 groups (noncirrhosis vs cirrhosis) based on APRI before and 3 months after the Kasai procedure. CONCLUSION: APRI may be used as a simple and readily available tool for assessing liver fibrosis without additional risks in patients with BA during postoperative follow-up care.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005176-201008000-00016&LSLINK=80&D=ovft
DOI
10.1097/MPG.0b013e3181da1d98
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Sang Yong(김상용)
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101387
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