Serum bile acids as a prognostic biomarker in biliary atresia following Kasai portoenterostomy
dc.contributor.author | Harpavat, Sanjiv | |
dc.contributor.author | Hawthorne, Kieran | |
dc.contributor.author | Setchell, Kenneth D. R. | |
dc.contributor.author | Narvaez Rivas, Monica | |
dc.contributor.author | Henn, Lisa | |
dc.contributor.author | Beil, Charlotte A. | |
dc.contributor.author | Karpen, Saul J. | |
dc.contributor.author | Ng, Vicky L. | |
dc.contributor.author | Alonso, Estella M. | |
dc.contributor.author | Bezerra, Jorge A. | |
dc.contributor.author | Guthery, Stephen L. | |
dc.contributor.author | Horslen, Simon | |
dc.contributor.author | Loomes, Kathy M. | |
dc.contributor.author | McKiernan, Patrick | |
dc.contributor.author | Magee, John C. | |
dc.contributor.author | Merion, Robert M. | |
dc.contributor.author | Molleston, Jean P. | |
dc.contributor.author | Rosenthal, Philip | |
dc.contributor.author | Thompson, Richard J. | |
dc.contributor.author | Wang, Kasper S. | |
dc.contributor.author | Sokol, Ronald J. | |
dc.contributor.author | Shneider, Benjamin L. | |
dc.contributor.author | Childhood Liver Disease Research Network (ChiLDReN) | |
dc.contributor.department | Pediatrics, School of Medicine | |
dc.date.accessioned | 2023-10-31T10:36:12Z | |
dc.date.available | 2023-10-31T10:36:12Z | |
dc.date.issued | 2023 | |
dc.description.abstract | Background and aims: In biliary atresia, serum bilirubin is commonly used to predict outcomes after Kasai portoenterostomy (KP). Infants with persistently high levels invariably need liver transplant, but those achieving normalized levels have a less certain disease course. We hypothesized that serum bile acid levels could help predict outcomes in the latter group. Approach and results: Participants with biliary atresia from the Childhood Liver Disease Research Network were included if they had normalized bilirubin levels 6 months after KP and stored serum samples from the 6-month post-KP clinic visit ( n = 137). Bile acids were measured from the stored serum samples and used to divide participants into ≤40 μmol/L ( n = 43) or >40 μmol/L ( n = 94) groups. At 2 years of age, the ≤40 μmol/L compared with >40 μmol/L group had significantly lower total bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, bile acids, and spleen size, as well as significantly higher albumin and platelet counts. Furthermore, during 734 person-years of follow-up, those in the ≤40 μmol/L group were significantly less likely to develop splenomegaly, ascites, gastrointestinal bleeding, or clinically evident portal hypertension. The ≤40 μmol/L group had a 10-year cumulative incidence of liver transplant/death of 8.5% (95% CI: 1.1%-26.1%), compared with 42.9% (95% CI: 28.6%-56.4%) for the >40 μmol/L group ( p = 0.001). Conclusions: Serum bile acid levels may be a useful prognostic biomarker for infants achieving normalized bilirubin levels after KP. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Harpavat S, Hawthorne K, Setchell KDR, et al. Serum bile acids as a prognostic biomarker in biliary atresia following Kasai portoenterostomy. Hepatology. 2023;77(3):862-873. doi:10.1002/hep.32800 | |
dc.identifier.uri | https://hdl.handle.net/1805/36787 | |
dc.language.iso | en_US | |
dc.publisher | Wolters Kluwer | |
dc.relation.isversionof | 10.1002/hep.32800 | |
dc.relation.journal | Hepatology | |
dc.rights | Attribution-NonCommercial 4.0 International | en |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.source | PMC | |
dc.subject | Biliary atresia | |
dc.subject | Hepatic portoenterostomy | |
dc.subject | Bilirubin | |
dc.subject | Biomarkers | |
dc.subject | Treatment outcome | |
dc.title | Serum bile acids as a prognostic biomarker in biliary atresia following Kasai portoenterostomy | |
dc.type | Article |