Multivariate analysis of biliary flow-related factors and post-kasai survival in biliary atresia patients
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
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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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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1816829571525246976 |