Transient elastography is useful in diagnosing biliary atresia and predicting prognosis after hepatoportoenterostomy

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Jia-Feng WuMei-Hwei Chang

Abstract

We investigated the utility of transient elastography (TE) for diagnosing biliary atresia (BA) in cholestatic infants and predicting the outcome of BA. Forty-eight cholestatic infants (9-87 days of age) with direct bilirubin level >1 mg/dL were enrolled. Liver stiffness measurement (LSM) by TE was performed during the cholestasis workup, and 15 subjects were diagnosed as BA. We assessed liver histology using liver biopsies from 36 subjects and graded fibrosis status using the METAVIR score. BA infants had significantly higher LSM values and METAVIR scores than non-BA cholestatic infants. A receiver operating characteristic (ROC) curve analysis showed that an LSM >7.7 kPa was predictive of BA among cholestatic infants (sensitivity = 80%; specificity = 97%; area under the curve [AUC] = 85.3%; P = 0.0001). Cholestatic infants with an LSM >7.7 kPa were more likely to be diagnosed with BA (odds ratio [OR] = 128; P < 0.001). Very early measurement of LSM after hepatoportoenterostomy (HPE) is associated with occurrence of thrombocytopenia, splenomegaly, and esophageal varices 6 months post-HPE. Five of the BA subjects were awaiting or had received liver transplantation (LT), and they had a significantly higher LSM measured 1 week post...Continue Reading

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Citations

Apr 14, 2019·Journal of Hepato-biliary-pancreatic Sciences·Florian FriedmacherMark Davenport
Jul 25, 2019·Journal of Pediatric Gastroenterology and Nutrition·Krupa R MysoreSanjiv Harpavat
Mar 25, 2020·JAMA : the Journal of the American Medical Association·Sanjiv HarpavatBenjamin L Shneider
Jul 12, 2020·Liver International : Official Journal of the International Association for the Study of the Liver·Azza A TantawyHesham I Elsantiel
Mar 5, 2019·F1000Research·Andrew WehrmanRebecca G Wells
Oct 12, 2018·World Journal of Pediatrics : WJP·Lucija RuzmanGoran Palcevski
Mar 7, 2020·Clinical Liver Disease·Mary Elizabeth M Tessier, Benjamin L Shneider
Nov 21, 2020·Indian Journal of Pediatrics·Quan-Yuan ShanLu-Yao Zhou
Jan 12, 2021·Frontiers in Pediatrics·Kotaro OgawaYoshikazu Kawabe
Feb 12, 2021·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Huadong ChenXiaoyan Xie
Sep 4, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Giovanna FerraioliJonathan R Dillman
Mar 13, 2019·The Journal of Pediatrics·Sanjiv Harpavat

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