Fischler Björn, Svensson Jan F, Nemeth Antal
Department of Pediatrics, Karolinska University Hospital, CLINTEC, Karolinska Intitutet, Stockholm, Sweden.
Acta Paediatr. 2009 Oct;98(10):1600-2. doi: 10.1111/j.1651-2227.2009.01416.x. Epub 2009 Jul 9.
To study the impact of ongoing cytomegalovirus (CMV) infection at presentation of biliary atresia (BA) on the long-term outcome after Kasai procedure.
Twenty-eight patients with BA born 1988-1997 were included and followed-up until 2007. Eleven patients (group A) had ongoing CMV infection at presentation and were compared to the remaining 17 patients (group B). Median age at Kasai procedure was 75 days in group A and 70 days in group B (p = 0.12).
Including all patients, survival with native liver was 50% and 36% at 4 and 10 years of follow-up respectively. At the end of follow-up, it was 25% and overall survival was 68%. When comparing groups A and B, neither difference in survival with native liver (p = 0.67, log-rank test) nor in survival after liver transplantation was detected.
Survival with native liver after Kasai procedure is comparable to that of other centres. CMV positive patients may present with a later onset, alternatively the detection of CMV infection could delay the referral of BA patients. No significant differences in long-term outcome were detected with regard to early CMV infection.
研究胆道闭锁（BA）患儿就诊时存在的巨细胞病毒（CMV）感染对Kasai手术后长期预后的影响。
纳入1988年至1997年出生的28例BA患儿，并随访至2007年。11例患儿（A组）就诊时存在CMV感染，与其余17例患儿（B组）进行比较。A组Kasai手术时的中位年龄为75天，B组为70天（p = 0.12）。
纳入所有患儿，随访4年和10年时自体肝存活分别为50%和36%。随访结束时，自体肝存活率为25%，总生存率为68%。比较A组和B组，未发现自体肝存活率（p = 0.67，对数秩检验）和肝移植后存活率存在差异。
Kasai手术后自体肝存活率与其他中心相当。CMV阳性患儿可能起病较晚，或者CMV感染的检测可能会延迟BA患儿的转诊。早期CMV感染在长期预后方面未发现显著差异。
