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Clinical Benefit of Liver Stiffness Measurement at 3 Months after Kasai Hepatoportoenterostomy to Predict the Liver Related Events in Biliary Atresia

Authors
 Seung Min Hahn  ;  Seung Kim  ;  Kook In Park  ;  Seok Joo Han  ;  Hong Koh 
Citation
 PLoS One, Vol.8(11) : e80652, 2013 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2013
MeSH
Biliary Atresia/diagnosis* ; Biliary Atresia/etiology* ; Biliary Atresia/surgery ; Child ; Child, Preschool ; Elasticity Imaging Techniques*/methods ; Elasticity Imaging Techniques*/standards ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Liver/diagnostic imaging* ; Liver/pathology* ; Liver/surgery ; Liver Function Tests ; Male ; Prognosis ; ROC Curve ; Reference Values ; Reproducibility of Results ; Risk Factors
Keywords
Biliary Atresia/diagnosis* ; Biliary Atresia/etiology* ; Biliary Atresia/surgery ; Child ; Child, Preschool ; Elasticity Imaging Techniques*/methods ; Elasticity Imaging Techniques*/standards ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Liver/diagnostic imaging* ; Liver/pathology* ; Liver/surgery ; Liver Function Tests ; Male ; Prognosis ; ROC Curve ; Reference Values ; Reproducibility of Results ; Risk Factors
Abstract
BACKGROUND: The progression of hepatic fibrosis may result in decompensated hepatic failure with cirrhosis, liver related events (LRE) such as ascites, variceal bleeding, and death after successful and timely Kasai hepatoportoenterostomy (HPE) in biliary atresia. The aim of this study is to suggest clinical benefit of the liver stiffness measurement (LSM) using transient elastography at 3 months after the Kasai operation to predict LRE. METHODS: Between January 2007 and December 2011, 69 eligible biliary atresia patients who underwent Kasai HPE and performed transient elastography before and 3 months after HPE were included. The occurrences of LRE were analyzed for all patients. All patients were divided into 2 groups (with and without LRE) for comparison. Multivariate analysis was used to detect the independent risk factors of LRE. The area under the receiver operation characteristics curve (AUROC) was used to establish the LSM optimal cutoff value of 3 months after Kasai operation in predicting LRE. RESULTS: LSM value, aminotransferase, albumin, bilirubin, and PT-INR significantly differed among the two groups. Multivariate analysis demonstrated LSM value as the most powerful independent factor of the development of LRE. The cut-off value of 19.9 kPa was calculated to be optimal for predicting LRE development with total sensitivity and specificity of 1.804. AUROC resulted in 0.943, with sensitivity of 85.3% and specificity of 95.2%. CONCLUSIONS: The LSM value of 3 months after Kasai HPE can be a useful predictor of LRE development.
Files in This Item:
T201305763.pdf Download
DOI
10.1371/journal.pone.0080652
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, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Park, Kook In(박국인) ORCID logo https://orcid.org/0000-0001-8499-9293
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89214
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