https://scholars.lib.ntu.edu.tw/handle/123456789/587741
標題: | Serum bile acid levels assist the prediction of biliary stricture and survival after liver transplantation in children | 作者: | JIA-FENG WU Boo, Yin-Ann MING-CHIH HO HUEY-LING CHEN HONG-YUAN HSU Chang, Mei-Hwei |
關鍵字: | Bile acid; Biliary atresia; Biliary complications; Liver transplant; Outcome predictors | 公開日期: | 八月-2021 | 卷: | 180 | 期: | 8 | 來源出版物: | European journal of pediatrics | 摘要: | Biliary stricture is an important biliary complication after liver transplant in children. We aimed to investigate the utility of serum bile acid levels for prediction of biliary stricture in children after liver transplant. This study enrolled 60 children who underwent liver transplantation at a mean age of 2.04±0.30 years; serum bile acid levels were surveyed in a cross-sectional design. These patients were followed regularly at our institute, and the clinical data were collected prospectively. The major indication of liver transplant in this pediatric cohort was biliary atresia (78.33%). During the follow-up period (3.08±0.30 years), nine patients (15%) developed biliary stricture after the check of serum bile acid. A receiver operating characteristic curve analysis yielded a serum bile acid cutoff of >40 μM for the prediction of biliary stricture (P = 0.002). A serum bile acid level >40 is the most important predictor of a biliary stricture after liver transplant (odds ratio=65.65, P = 0.003) after adjusting for gender and GGT levels. The phenomenon remained on Cox's proportional hazard survival analysis (hazard ratio =15.42, P = 0.001). The mortality risk after liver transplant was significantly higher in subjects with serum bile acid levels >40 μM than in those with levels ≤40 μM (log-rank test, P = 0.004).Conclusion: Serum bile acid levels can be used for non-invasive screening and prediction of biliary stricture and mortality in children after liver transplantation. What is Known: • Biliary stricture is a major biliary complication after pediatric liver transplantation, and we showed the serum bile acid level significantly associates with biliary stricture. What is New: • In this study, we demonstrated the serum bile acid level may assist in the early detection of biliary stricture and mortality non-invasively. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/587741 | ISSN: | 03406199 | DOI: | 10.1007/s00431-021-04098-9 | SDG/關鍵字: | alanine aminotransferase; alkaline phosphatase; bile acid; bilirubin; bilirubin glucuronide; cyclosporine; gamma glutamyltransferase; tacrolimus; bile acid; Alagille syndrome; alanine aminotransferase blood level; alkaline phosphatase blood level; Article |
顯示於: | 醫學系 |
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