Does time taken to achieve jaundice-clearance influence survival of the native liver in post-Kasai biliary atresia?
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ORIGINAL ARTICLE
Does time taken to achieve jaundice‑clearance influence survival of the native liver in post‑Kasai biliary atresia? Hideaki Nakajima1 · Hiroyuki Koga1 · Manabu Okawada1 · Hiroki Nakamura1 · Geoffrey James Lane1 · Atsuyuki Yamataka1 Received: 31 January 2017 / Revised: 13 March 2017 / Accepted: 15 March 2017 © Children’s Hospital, Zhejiang University School of Medicine 2018
Abstract Background We reviewed the time taken for post-portoenterostomy (PE) biliary atresia (BA) patients to obtain jaundiceclearance (total bilirubin ≤ 1.2 mg/dL; JC) post-PE to determine if JC time (JCT) is prognostic for survival of the native liver (SNL). Methods The subjects were 66 BA patients treated with PE at our institute between 1989, the year when liver transplantation (LTx) became available in Japan, and 2014. JCT was used to create three groups (≤ 30 days: n = 14; 31–60 days: n = 31; ≥ 61 days: n = 21). Medical records were reviewed retrospectively to evaluate: age at onset of symptoms, duration of symptoms pre-PE, age and weight at PE, serum liver function tests, incidence of cholangitis, and micro-bile duct size at PE. Results Age at onset of symptoms, age and weight at PE, duration of symptoms pre-PE, and micro-bile duct size were similar for all patients in all three groups. JCT and SNL appeared to correlate because preoperative total bilirubin (7.1, 9.6, 10.2 mg/ dL; P
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