Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients

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dc.creatorAlexandre Rodriguesferreira
dc.creatorThaís Costa Nascentes Queiroz
dc.creatorPaula Vieira Teixeira Vidigal
dc.creatorRaquel di Paula Ferreira
dc.creatorDavid Campos Wanderley
dc.creatorEleonora Druve Tavares Fagundes
dc.date.accessioned2023-12-06T21:40:53Z
dc.date.accessioned2025-09-09T01:24:28Z
dc.date.available2023-12-06T21:40:53Z
dc.date.issued2019
dc.format.mimetypepdf
dc.identifier.doi10.1590/s0004-2803.201900000-18
dc.identifier.issn16784219
dc.identifier.urihttps://hdl.handle.net/1843/61825
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofArquivos de Gastroenterologia
dc.rightsAcesso Aberto
dc.subjectBiliary Atresia
dc.subjectCholestasis
dc.subjectInfant, Newborn
dc.subjectPrognosis
dc.subjectLiver Transplantation
dc.subjectPortoenterostomy, Hepatic
dc.subject.otherBiliary Atresia
dc.subject.otherCholestasis
dc.subject.otherNewborn infant
dc.subject.otherPrognosis
dc.subject.otherLiver transplantation
dc.subject.otherPortoenterostomy, Hepatic
dc.titleMultivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
dc.typeArtigo de periódico
local.citation.epage78
local.citation.issue1
local.citation.spage71
local.citation.volume56
local.description.resumoABSTRACT – 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.
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.initialsUFMG
local.url.externahttps://doi.org/10.1590/S0004-2803.201900000-18

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