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A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy

Background: Although Kasai portoenterostomy (KPE) is performed timely for most children with biliary atresia (BA), the native liver survival (NLS) is still poor due to the progressive liver fibrosis. Many children have to receive liver transplantation (LT) within 2 years after KPE. Early prediction...

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Autores principales: Liu, Jin-qiao, Chen, Wen-juan, Zhou, Meng-jie, Li, Wen-feng, Tang, Ju, Zhou, Qi-chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943446/
https://www.ncbi.nlm.nih.gov/pubmed/33718307
http://dx.doi.org/10.3389/fped.2021.641318
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author Liu, Jin-qiao
Chen, Wen-juan
Zhou, Meng-jie
Li, Wen-feng
Tang, Ju
Zhou, Qi-chang
author_facet Liu, Jin-qiao
Chen, Wen-juan
Zhou, Meng-jie
Li, Wen-feng
Tang, Ju
Zhou, Qi-chang
author_sort Liu, Jin-qiao
collection PubMed
description Background: Although Kasai portoenterostomy (KPE) is performed timely for most children with biliary atresia (BA), the native liver survival (NLS) is still poor due to the progressive liver fibrosis. Many children have to receive liver transplantation (LT) within 2 years after KPE. Early prediction of the prognosis permits the implementation of prophylactic treatments for BA children. However, studies about the prediction are limited. Objective: The purpose of this study is to establish a nomogram to predict the prognosis of BA children within 2 years after KPE. Methods: The follow-up data of 151 BA children were retrospectively reviewed, and were randomly divided into a training cohort for constructing a nomogram (n = 103) and a validation cohort (n = 48). In the training cohort, patients were divided into Group A and Group B according to whether death or LT were observed within 2 years post-KPE. Multivariate Cox regression based on the baseline characteristics, liver function indicators and LSM (liver stiffness measurement) values at KPE and 3 months after KPE was utilized for the establishment of the nomogram in predicting the prognosis of BA within 2 years after KPE. The discrimination and calibration of the nomogram were internally and externally validated. Results: Fifty-six BA children were included in Group A and 47 were included in group B. Age at KPE, METAVIR score F4, LSM at 3 months, first onset of cholangitis within 3 months, and jaundice clearance time were the independent predictors for the prognosis of BA children within 2 years after KPE (all P < 0.05). The developed nomogram based on these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than each predictor in predicting the prognosis (all P < 0.05). Conclusions: The established nomogram based on the indicators from the first 3 months after KPE may be useful for predicting the prognosis of BA children within 2 years post-KPE and helpful for the consideration of LT.
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spelling pubmed-79434462021-03-11 A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy Liu, Jin-qiao Chen, Wen-juan Zhou, Meng-jie Li, Wen-feng Tang, Ju Zhou, Qi-chang Front Pediatr Pediatrics Background: Although Kasai portoenterostomy (KPE) is performed timely for most children with biliary atresia (BA), the native liver survival (NLS) is still poor due to the progressive liver fibrosis. Many children have to receive liver transplantation (LT) within 2 years after KPE. Early prediction of the prognosis permits the implementation of prophylactic treatments for BA children. However, studies about the prediction are limited. Objective: The purpose of this study is to establish a nomogram to predict the prognosis of BA children within 2 years after KPE. Methods: The follow-up data of 151 BA children were retrospectively reviewed, and were randomly divided into a training cohort for constructing a nomogram (n = 103) and a validation cohort (n = 48). In the training cohort, patients were divided into Group A and Group B according to whether death or LT were observed within 2 years post-KPE. Multivariate Cox regression based on the baseline characteristics, liver function indicators and LSM (liver stiffness measurement) values at KPE and 3 months after KPE was utilized for the establishment of the nomogram in predicting the prognosis of BA within 2 years after KPE. The discrimination and calibration of the nomogram were internally and externally validated. Results: Fifty-six BA children were included in Group A and 47 were included in group B. Age at KPE, METAVIR score F4, LSM at 3 months, first onset of cholangitis within 3 months, and jaundice clearance time were the independent predictors for the prognosis of BA children within 2 years after KPE (all P < 0.05). The developed nomogram based on these independent predictors showed good discrimination and calibration by the internal and external validation. Its performance was better than each predictor in predicting the prognosis (all P < 0.05). Conclusions: The established nomogram based on the indicators from the first 3 months after KPE may be useful for predicting the prognosis of BA children within 2 years post-KPE and helpful for the consideration of LT. Frontiers Media S.A. 2021-02-24 /pmc/articles/PMC7943446/ /pubmed/33718307 http://dx.doi.org/10.3389/fped.2021.641318 Text en Copyright © 2021 Liu, Chen, Zhou, Li, Tang and Zhou. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Liu, Jin-qiao
Chen, Wen-juan
Zhou, Meng-jie
Li, Wen-feng
Tang, Ju
Zhou, Qi-chang
A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title_full A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title_fullStr A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title_full_unstemmed A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title_short A Nomogram Predicting the Prognosis of Children With Biliary Atresia After Hepatoportoenterostomy
title_sort nomogram predicting the prognosis of children with biliary atresia after hepatoportoenterostomy
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943446/
https://www.ncbi.nlm.nih.gov/pubmed/33718307
http://dx.doi.org/10.3389/fped.2021.641318
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