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The Albumin-bilirubin Score Detects Changes in the Liver Function during Treatment for Budd-Chiari Syndrome: A
Ken Kageyama1, Akira Yamamoto1, Atsushi Jogo1
1Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, Japan.
Insights
The albumin-bilirubin (ALBI) score effectively tracks liver function changes in Budd-Chiari syndrome (BCS) patients over time, unlike the Child-Pugh score. Percutaneous old balloon angioplasty (POBA) treatment showed improved ALBI scores in BCS patients.
Area of Science:
- Hepatology
- Interventional Radiology
- Medical Prognostics
Background:
- Budd-Chiari syndrome (BCS) prognosis is challenging due to variable liver function.
- Assessing long-term liver function changes is crucial for BCS management.
- Existing scoring systems may not fully capture dynamic liver function shifts in BCS.
Purpose of the Study:
- To compare the efficacy of the albumin-bilirubin (ALBI) score and Child-Pugh score in evaluating long-term liver function changes in Budd-Chiari syndrome (BCS) patients.
- To assess the impact of percutaneous old balloon angioplasty (POBA) on liver function over time.
- To investigate the relationship between liver function, re-stenosis, and re-treatment in BCS.
Main Methods:
- Retrospective study of 13 BCS patients (2007-2020).
- Patients divided into a treatment group (n=8, POBA) and a non-treatment group (n=5).
- Liver function assessed using ALBI and Child-Pugh scores at initial visit, 1-year, and 3-year follow-up.
Main Results:
- ALBI scores significantly improved in the POBA treatment group at 1- and 3-year follow-ups (p=0.0078 and 0.0156).
- Child-Pugh scores showed no significant change in the treatment group.
- ALBI scores indicated gradual improvement in the treatment group and worsening in the non-treatment group, correlating with re-stenosis and re-POBA events.
Conclusions:
- The ALBI score is a more sensitive tool than the Child-Pugh score for detecting long-term liver function changes in BCS patients.
- POBA treatment is associated with improved liver function as measured by the ALBI score.
- ALBI score variations reflect the impact of interventions and disease progression in BCS.
Abstract:
Objective Mapping the long-term prognosis of Budd-Chiari syndrome (BCS) is difficult, as the prognosis is associated with changes in the liver function. The present study evaluated the time course changes in the liver function in a treatment group with percutaneous old balloon angioplasty (POBA) and a non-treatment group using the albumin-bilirubin score (ALBI) and Child-Pugh score during long-term follow-up. Methods In this retrospective study, 13 consecutive patients diagnosed with BCS at our hospital between 2007 and 2020 were categorized into a treatment group (n=8), which received POBA, and a non-treatment group (n=5). Differences in the liver function in the ALBI and Child-Pugh scores between the initial visit and one- and three-year follow-up were calculated and statistically evaluated. We investigated the changes in the liver function during the long-term follow-up, including events such as re-stenosis and re-treatment. Results While the Child-Pugh scores in the treatment group did not differ significantly between the initial visit and 1- or 3-year follow-up, the ALBI scores in this group improved significantly between the initial visit and the 1- or 3-year follow-up visit (p=0.0078 and 0.0156, respectively). The liver function according to the ALBI score in the treatment group showed gradual improvement from the initial value but gradual worsening in the non-treatment group. The ALBI scores also revealed that the liver function varies according to re-stenosis and re-POBA in BCS patients. Conclusion Unlike the Child-Pugh score, the ALBI score was able to capture changes in the liver function of BCS patients during the long-term course of BCS.
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