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

Detalhes bibliográficos
Autor(a) principal: Alexandre Rodriguesferreira
Data de Publicação: 2019
Outros Autores: Thaís Costa Nascentes Queiroz, Paula Vieira Teixeira Vidigal, Raquel di Paula Ferreira, David Campos Wanderley, Eleonora Druve Tavares Fagundes
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFMG
Texto Completo: http://hdl.handle.net/1843/61825
Resumo: 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.
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spelling Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patientsBiliary AtresiaCholestasisNewborn infantPrognosisLiver transplantationPortoenterostomy, HepaticBiliary AtresiaCholestasisInfant, NewbornPrognosisLiver TransplantationPortoenterostomy, HepaticABSTRACT – 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.Universidade Federal de Minas GeraisBrasilMED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGALMED - DEPARTAMENTO DE PEDIATRIAUFMG2023-12-06T21:40:53Z2023-12-06T21:40:53Z2019info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlepdfapplication/pdf10.1590/s0004-2803.201900000-1816784219http://hdl.handle.net/1843/61825engArquivos de GastroenterologiaAlexandre RodriguesferreiraThaís Costa Nascentes QueirozPaula Vieira Teixeira VidigalRaquel di Paula FerreiraDavid Campos WanderleyEleonora Druve Tavares Fagundesinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMG2023-12-07T00:34:07Zoai:repositorio.ufmg.br:1843/61825Repositório InstitucionalPUBhttps://repositorio.ufmg.br/oairepositorio@ufmg.bropendoar:2023-12-07T00:34:07Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
dc.title.none.fl_str_mv Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
title Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
spellingShingle Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
Alexandre Rodriguesferreira
Biliary Atresia
Cholestasis
Newborn infant
Prognosis
Liver transplantation
Portoenterostomy, Hepatic
Biliary Atresia
Cholestasis
Infant, Newborn
Prognosis
Liver Transplantation
Portoenterostomy, Hepatic
title_short Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
title_full Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
title_fullStr Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
title_full_unstemmed Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
title_sort Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
author Alexandre Rodriguesferreira
author_facet Alexandre Rodriguesferreira
Thaís Costa Nascentes Queiroz
Paula Vieira Teixeira Vidigal
Raquel di Paula Ferreira
David Campos Wanderley
Eleonora Druve Tavares Fagundes
author_role author
author2 Thaís Costa Nascentes Queiroz
Paula Vieira Teixeira Vidigal
Raquel di Paula Ferreira
David Campos Wanderley
Eleonora Druve Tavares Fagundes
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Alexandre Rodriguesferreira
Thaís Costa Nascentes Queiroz
Paula Vieira Teixeira Vidigal
Raquel di Paula Ferreira
David Campos Wanderley
Eleonora Druve Tavares Fagundes
dc.subject.por.fl_str_mv Biliary Atresia
Cholestasis
Newborn infant
Prognosis
Liver transplantation
Portoenterostomy, Hepatic
Biliary Atresia
Cholestasis
Infant, Newborn
Prognosis
Liver Transplantation
Portoenterostomy, Hepatic
topic Biliary Atresia
Cholestasis
Newborn infant
Prognosis
Liver transplantation
Portoenterostomy, Hepatic
Biliary Atresia
Cholestasis
Infant, Newborn
Prognosis
Liver Transplantation
Portoenterostomy, Hepatic
description 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.
publishDate 2019
dc.date.none.fl_str_mv 2019
2023-12-06T21:40:53Z
2023-12-06T21:40:53Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv 10.1590/s0004-2803.201900000-18
16784219
http://hdl.handle.net/1843/61825
identifier_str_mv 10.1590/s0004-2803.201900000-18
16784219
url http://hdl.handle.net/1843/61825
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Arquivos de Gastroenterologia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Minas Gerais
Brasil
MED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL
MED - DEPARTAMENTO DE PEDIATRIA
UFMG
publisher.none.fl_str_mv Universidade Federal de Minas Gerais
Brasil
MED - DEPARTAMENTO DE ANATOMIA PATOLÓGICA E MEDICINA LEGAL
MED - DEPARTAMENTO DE PEDIATRIA
UFMG
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMG
instname:Universidade Federal de Minas Gerais (UFMG)
instacron:UFMG
instname_str Universidade Federal de Minas Gerais (UFMG)
instacron_str UFMG
institution UFMG
reponame_str Repositório Institucional da UFMG
collection Repositório Institucional da UFMG
repository.name.fl_str_mv Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)
repository.mail.fl_str_mv repositorio@ufmg.br
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