Chen Szu-Ying, Lin Chieh-Chung, Tsan Yu-Tse, Chan Wei-Cheng, Wang Jiaan-Der, Chou Yi-Jung, Lin Ching-Heng
Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, 40705, Taichung, Taiwan, Republic of China.
Wuri Lin Shin Hospital, Taichung, Taiwan.
BMC Pediatr. 2018 Apr 2;18(1):119. doi: 10.1186/s12887-018-1074-2.
Cholangitis may affect liver failure of biliary atresia (BA) patients after Kasai portoenterostomy (KP). We examined whether the number of cholangitis episodes could be a prognostic marker for liver transplant (LT) in children with BA after Kasai portoenterostomy (KP).
Data for BA patients born after 1998 and undergoing KP were obtained from National Health Insurance Research Database (NHIRD), Taiwan. Patients were followed up until the end of 2011. Incidence and the number of cholangitis episodes were recorded and compared between patients based on LT status.
Ninety-six (26.8%) of the 366 BA patients underwent LT. More patients who underwent KP at < 60 days of age survived with their native liver (P = 0.007). The mean age at first cholangitis was 0.9 years and 0.8 years in the LT and non-LT groups, respectively (P = 0.868). The cumulative incidence of cholangitis within 2 years after KP did not differ between the groups (hazard ratio 1.2; 95% CI 0.9-1.6). However, the total number of cholangitis episodes was higher in the LT group within 2 years after KP (P < 0.001).
Cholangitis occurrence was not related to LT in the first 2 years after KP in BA patients, but the number of cholangitis episodes could be a prognostic marker for future LT.
胆管炎可能影响肝门空肠吻合术（KP）后胆道闭锁（BA）患者的肝衰竭情况。我们研究了胆管炎发作次数是否可作为肝门空肠吻合术（KP）后BA患儿肝移植（LT）的预后标志物。
从台湾国民健康保险研究数据库（NHIRD）获取1998年后出生并接受KP的BA患者数据。对患者进行随访至2011年底。记录胆管炎的发病率和发作次数，并根据LT状态在患者之间进行比较。
366例BA患者中有96例（26.8%）接受了LT。60日龄前接受KP的患者中，更多患者存活且肝脏未移植（P = 0.007）。LT组和非LT组首次发生胆管炎的平均年龄分别为0.9岁和0.8岁（P = 0.868）。KP后2年内胆管炎的累积发病率在两组之间无差异（风险比1.2；95%置信区间0.9 - 1.6）。然而，KP后2年内LT组的胆管炎发作总数更高（P < 0.001）。
BA患者在KP后的前2年，胆管炎的发生与LT无关，但胆管炎发作次数可能是未来LT的预后标志物。
