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Correlation between gamma-glutamyl transpeptidase activity and outcomes after Kasai portoenterostomy for biliary atresia

Authors
 Kyong Ihn  ;  In Geol Ho  ;  Eun Young Chang  ;  Seok Joo Han 
Citation
 Journal of Pediatric Surgery, Vol.53(3) : 461-467, 2018 
Journal Title
 Journal of Pediatric Surgery 
ISSN
 0022-3468 
Issue Date
2018
Keywords
Aspartate aminotransferase-to-platelet ratio index ; Biliary atresia ; Gamma-glutamyl transpeptidase ; Kasai portoenterostomy ; Prognosis
Abstract
BACKGROUND/PURPOSE: The role of serum gamma-glutamyl transpeptidase (GGT) levels in predicting clinical outcomes after Kasai portoenterostomy (KPE) is unknown. This study analyzed whether postoperative GGT along with the aspartate aminotransferase-to-platelet ratio index (APRi) predicted prognosis of biliary atresia (BA). METHODS: Data were retrospectively reviewed for 169 BA patients categorized into jaundice-free (JF) (total bilirubin <2.0 mg/dL </=6 months post-KPE) and persistent jaundice (PJ) groups (total bilirubin >/=2.0 mg/dL </=6 months post-KPE). Serum biochemical markers, including GGT levels, were measured monthly after KPE, and mean GGT levels and APRi were compared between groups. Factors predicting native liver survival (NLS) were determined using a Cox regression analysis. RESULTS: GGT concentrations >550 IU/L at month 5 (hazard ratio: 1.74, P < 0.05), an APRi >0.605 at month 4 (hazard ratio: 3.78, P = 0.001), and being jaundice-free at 6 months (hazard ratio: 5.49, P < 0.001) were independent risk factors for decreased NLS. CONCLUSIONS: Serum GGT concentrations >550 IU/L at month 5 and an APRi >0.605 at month 4 post-KPE were associated with significantly lower NLS rates. Among JF patients, those with GGT concentrations >550 IU/L at month 5 and APRi >0.605 at month 4 showed poorer outcomes. TYPE OF STUDY: Retrospective comparative study LEVEL OF EVIDENCE: Level III.
Full Text
https://www.sciencedirect.com/science/article/pii/S0022346817306164
DOI
10.1016/j.jpedsurg.2017.10.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Ihn, Kyong(인경) ORCID logo https://orcid.org/0000-0002-6161-0078
Chang, Eun Young(장은영)
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
Hu, Jen Chien(호인걸)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162197
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