Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening.

Details

Serval ID
serval:BIB_3FBD63B0D907
Type
Article: article from journal or magazin.
Collection
Publications
Title
Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening.
Journal
Pediatrics
Author(s)
Serinet M.O., Wildhaber B.E., Broué P., Lachaux A., Sarles J., Jacquemin E., Gauthier F., Chardot C.
ISSN
1098-4275 (Electronic)
ISSN-L
0031-4005
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
123
Number
5
Pages
1280-1286
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
BACKGROUND: Increased age at surgery has a negative impact on results of the Kasai operation for biliary atresia in infancy and early childhood. It remained unclear if an age threshold exists and if this effect persists with extended follow-up. In this study we examined the relationship between increased age at surgery and its results in adolescence.
METHODS: All patients with biliary atresia who were living in France and born between 1986 and 2002 were included. Median follow-up in survivors was 7 years.
RESULTS: Included in the study were 743 patients with biliary atresia, 695 of whom underwent a Kasai operation; 2-, 5-, 10-, and 15-year survival rates with native liver were 57.1%, 37.9%, 32.4%, and 28.5%, respectively. Median age at Kasai operation was 60 days and was stable over the study period. Whatever the follow-up (2, 5, 10, or 15 years), survival rates with native liver decreased when age at surgery increased (< or =30, 31-45, 46-60, 61-75, and 76-90 days). Accordingly, we estimated that if every patient with biliary atresia underwent the Kasai operation before 46 days of age, 5.7% of all liver transplantations performed annually in France in patients younger than 16 years could be spared.
CONCLUSIONS: Increased age at surgery had a progressive and sustained deleterious effect on the results of the Kasai operation until adolescence. These findings indicate a rational basis for biliary atresia screening to reduce the need for liver transplantations in infancy and childhood.
Keywords
Adolescent, Age Factors, Biliary Atresia/diagnosis, Biliary Atresia/surgery, Child, Female, Humans, Infant, Infant, Newborn, Liver Transplantation/statistics & numerical data, Male, Neonatal Screening, Portoenterostomy, Hepatic, Prognosis, Retrospective Studies, Treatment Outcome
Pubmed
Web of science
Create date
21/02/2015 11:55
Last modification date
20/08/2019 13:37
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