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Related Concept Videos

Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Related Experiment Video

Updated: Jun 1, 2026

Partial Bile Duct Ligation in the Mouse: A Controlled Model of Localized Obstructive Cholestasis
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Multicenter Study on Early Predictors of Biliary Atresia Outcomes.

Maria Hukkinen1, Björn Fischler2, Ulrika Liliemark2

  • 1Section of Pediatric Surgery and Pediatric Liver and Gut Research Group, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Finland; ERN Rare-Liver, France.

Journal of Pediatric Surgery
|June 9, 2025
PubMed
Summary

The aspartate aminotransferase-to-platelet ratio index (APRI) is not superior to AST for predicting biliary atresia (BA) outcomes. Biliary atresia splenic malformation (BASM) significantly predicts shorter native liver survival, even in patients who achieve clearance of jaundice.

Keywords:
Aspartate aminotransferase to platelet ratio-indexBiliary atresiaClearance of jaundiceCytomegalovirusLiver transplantationNative liver survivalSplenic malformation

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Area of Science:

  • Pediatric Hepatology
  • Surgical Gastroenterology
  • Neonatal Surgery

Background:

  • Biliary atresia (BA) is a severe neonatal liver disease requiring prompt surgical intervention.
  • Predicting outcomes after portoenterostomy is crucial for patient management and prognosis.
  • Liver biochemistry, APRI, and patient characteristics are potential prognostic indicators.

Purpose of the Study:

  • To compare the predictive value of liver biochemistry, APRI, and patient characteristics for BA outcomes at the time of portoenterostomy.
  • To analyze predictors of jaundice clearance and native liver survival.

Main Methods:

  • Retrospective observational study involving seven tertiary centers.
  • Analysis of predictors for clearance of jaundice (COJ) and native liver survival (NLS) using logistic and Cox regression.
  • Definition of CMV-associated BA based on cytomegalovirus detection.

Main Results:

  • 58% of 630 patients achieved COJ.
  • Absence of cirrhosis, CMV infection, age <60 days at portoenterostomy, and lower AST/APRI predicted COJ.
  • COJ, biliary atresia splenic malformation (BASM), and portoenterostomy age >60 days predicted transplantation/death.
  • Among COJ patients, BASM predicted transplantation/death.

Conclusions:

  • APRI is not superior to AST in predicting BA outcomes.
  • In patients achieving COJ, AST and APRI are unrelated to NLS.
  • BASM is a strong predictor of shorter NLS, despite younger portoenterostomy age and similar COJ rates.
  • COJ is achievable in CMV-positive patients with similar NLS post-COJ.