Department of Pediatric Hepatology, Gleneagles Global Health City, Perumbakkam, Chennai, Tamil Nadu. Correspondence to: Dr Somashekara Hosaagrahara Ramakrishna, Department of Pediatric Hepatology, Gleneagles Global Health City, Perumbakkam, Chennai, Tamil Nadu 600 100.
Department of Pediatrics, Mazumdar Shaw Medical Centre, Narayana Health, Bangalore, Karnataka.
Indian Pediatr. 2023 Aug 15;60(8):655-658. Epub 2023 May 30.
We studied the modifiable prognostic factors that extend native liver survival at 2 years after Kasai portoenterostomy (KPE).
We reviewed hospital records of patients with neonatal cholestasis, with focus on infants diagnosed with biliary atresia in a tertiary care hospital between January, 2014 and May, 2021. We determined the association of outcome with clinical and laboratory variables.
Infants who underwent KPE at a median (IQR) age of 76 (72-79) days had best outcomes, with minimal severe post-KPE complications and 2-year survival rate of 84.6%, compared to other infants (younger and older days at KPE). The median (IQR) weight at KPE in this group was 4.66 (4.2, 5.0) kg.
In contrast to traditional recommendations, babies with median age at KPE of 76 days had superior native liver survival (84.6%) and reduced post-KPE complications, as compared to earlier KPE age. Nutritional status and weight of infant at KPE could be associated with this survival difference. This observation needs confirmation through multicentric prospective study.
我们研究了可改变的预后因素，这些因素可以延长卡塞氏（Kasai）门腔分流术后 2 年的自体肝存活率。
我们回顾了 2014 年 1 月至 2021 年 5 月在一家三级保健医院诊断为胆道闭锁的新生儿胆汁淤积症患者的住院记录。我们确定了结果与临床和实验室变量的关联。
在中位（IQR）年龄为 76（72-79）天接受卡塞氏门腔分流术（KPE）的婴儿中，术后严重并发症最少，2 年生存率为 84.6%，与其他婴儿（KPE 年龄较小和较大的婴儿）相比，结果最佳。该组 KPE 时的中位（IQR）体重为 4.66（4.2，5.0）kg。
与传统建议相反，KPE 年龄中位数为 76 天的婴儿与早期 KPE 年龄相比，具有更高的自体肝存活率（84.6%）和更少的术后并发症。KPE 时婴儿的营养状况和体重可能与这种生存差异有关。这一观察结果需要通过多中心前瞻性研究来证实。
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