APRi predicts native liver survival by reflecting portal fibrogenesis and hepatic neovascularization at the time of portoenterostomy in biliary atresia

Journal of Pediatric Surgery
Janne S SuominenMikko P Pakarinen

Abstract

Aspartate aminotransferase-to-platelet ratio index (APRi) may be useful noninvasive prognostic tool in biliary atresia (BA). We studied whether APRi predicts native liver survival and parallels biochemical and immunohistological signs of liver injury and fibrogenesis at the time of Kasai portoenterostomy (PE). Serum and liver specimens were obtained at PE from 29 BA patients for liver biochemistry including APRi, histology and immunohistochemical analysis of collagen 1, α-SMA and CD34. APRi values were related to native liver survival and other clinical data as well as serum liver biochemistry, liver histology and immunohistochemistry at PE. Median age at PE was 63 (range 7-141) days and median APRi was 0.92 (0.13-6.39). APRi had strong positive correlations with patient age (r=0.684, p<0.001) and biochemical signs of hepatocyte injury and cholestasis. APRi showed no significant correlations with Metavir (r=0.336, p=0.223) or Ishak (r=0.289, p=0.262) global fibrosis scores nor with liver collagen 1 expression (r=0.260, p=0.222). In contrast, portal fibrosis score (r=0.515, p=0.013), predominantly portal α-SMA expression (r=0.519, p=0.015) and amount CD34-positive microvessels in the centrizonal region (r=0.604, p=0.004) correla...Continue Reading

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Citations

Nov 7, 2017·Journal of Paediatrics and Child Health·Jue TangYi Gao
Oct 1, 2019·Journal of Pediatric Gastroenterology and Nutrition·Catalina JaramilloMichael Kyle Jensen
Oct 6, 2020·Frontiers in Pediatrics·Min DuShan Zheng
May 26, 2017·Clinical Liver Disease·Daniel H Leung
Feb 12, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Huadong ChenXiaoyan Xie

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