Bile lakes in patients with biliary atresia who presented with jaundice-free native liver survival indicating the risk of subsequent liver transplantation due to various factors
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In brief
In brief
Retrospective study of 68 biliary atresia patients with jaundice-free survival at 1 year post-Kasai identifies bile lakes as the strongest predictor of subsequent liver transplantation. Bile lakes correlate with multiple complications including cholangitis, GI hemorrhage, and hepatopulmonary syndrome, providing a quantifiable risk score for transplant need.
- Bile lakes are the strongest predictor of subsequent liver transplantation in BA patients with jaundice-free survival at 1 year post-PE.
- Bile lakes increase risk not only through cholangitis but also via GI hemorrhage and hepatopulmonary syndrome complications.
- Risk score combining bile lake presence and total bile acids (2.38×BL + 0.00466×TBA) predicts transplant need with 0.83 AUC.
- Among BA patients jaundice-free at 1 year, bile lake status significantly stratifies native liver survival outcomes.
- Early bile lake detection enables targeted monitoring for multi-system complications requiring transplant evaluation.
Written by the GCMD Library team from the article.
Abstract
Purpose
The prognostic factors of subsequent liver transplantation (LT) in patients with biliary atresia (BA) who presented with jaundice-free native liver survival were investigated.
Methods
This study retrospectively reviewed patients who underwent portoenterostomy (PE) for BA. Patients with jaundice-free native liver survival at 1 year postoperatively were divided into the autologous liver survivor and liver transplant recipient groups. Peri- and postoperative data were compared between the two groups.
Results
Among 97 patients with BA, 29 who received LT within 1 year after PE were excluded from the analysis. Further, 48 patients currently living with native liver and 20 who received LT after 1 year postoperatively were compared. Bile lake (BL) was the strongest risk factor of LT. The risk score was \(2.38*BLscore+0.00466*TBA\) , and the area under the receiver operating characteristic curve was 0.83. Patients with BL and those without significantly differed in terms of the native liver survival rate. Patients with BL who presented with not only cholangitis but also gastrointestinal hemorrhage and hepatopulmonary syndrome received LT.
Conclusion
BL can cause different pathologies. Moreover, it is an evident risk factor of subsequent LT in patients with BA who are living with native liver at 1 year after PE.