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Tipo:	Artigo de Periódico
Título:	Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
Autor(es):	Alexandre Rodriguesferreira Thaís Costa Nascentes Queiroz Paula Vieira Teixeira Vidigal Raquel di Paula Ferreira David Campos Wanderley Eleonora Druve Tavares Fagundes
Resumen:	ABSTRACT – Background – Biliary atresia represents the most common surgically treatable cause of cholestasis in newborns. If not corrected, secondary biliary cirrhosis invariably results. Objective – To evaluate, through multivariate analysis, the prognostic factors associated with the presence of biliary flow and survival with the native liver following Kasai portoenterostomy. Methods – The study analyzed data from 117 biliary atresia patients who underwent portoenterostomy and had suitable histological material for evaluation. A logistic regression model was used to assess the presence of biliary flow. Survival was investigated through Kaplan-Meier curves and Cox-adjusted models. Results – One third of patients achieved biliary flow and the median age at surgery was 81 days. Age at surgery, albumin, postoperative complications, biliary atresia structural malformation (BASM), liver architecture, larger duct diameter at porta hepatis, and cirrhosis (Ishak score) were the initial variables for the multivariate analysis. Age at surgery >90 days was the only variable associated with the absence of biliary drainage. Survival analysis revealed that the absence of biliary flow (P<0.0001), age at surgery >90 days (P=0.035), and the presence of BASM (P<0.0001), alone, could predict death or need for liver transplantation. Multivariate analysis demonstrated that the absence of biliary flow (P<0.0001 hazard ratio [HR] 6.25, 95% confidence interval [CI] 3.19–12.22) and the presence of BASM (P=0.014 HR 2.16, 95% CI 1.17–3.99) were associated with lowest survival with the native liver. Conclusion – Age at surgery >90 days was associated with absence of biliary flow. The presence of biliary drainage and the absence of structural malformations are cornerstone features for higher survival rates with the native liver.
Asunto:	Biliary Atresia Cholestasis Infant, Newborn Prognosis Liver Transplantation Portoenterostomy, Hepatic
Idioma:	eng
País:	Brasil
Editor:	Universidade Federal de Minas Gerais
Sigla da Institución:	UFMG
Departamento:	MED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL MED - DEPARTAMENTO DE PEDIATRIA
Tipo de acceso:	Acesso Aberto
Identificador DOI:	10.1590/s0004-2803.201900000-18
URI:	http://hdl.handle.net/1843/61825
Fecha del documento:	2019
metadata.dc.url.externa:	https://doi.org/10.1590/S0004-2803.201900000-18
metadata.dc.relation.ispartof:	Arquivos de Gastroenterologia
Aparece en las colecciones:	Artigo de Periódico

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