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Kasai Portoenterostomy at a Slightly Delayed Age and Native Liver Survival in Children With Biliary Atresia: Single Center Experience

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Abstract

Objectives

We studied the modifiable prognostic factors that extend native liver survival at 2 years after Kasai portoenterostomy (KPE).

Methods

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.

Results

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 age at KPE). The median (IQR) weight at KPE in this group was 4.66 (4.2, 5.0) kg.

Conclusions

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 studies in different settings.

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Funding

Funding: None

Author information

Authors and Affiliations

  1. Department of Pediatric Hepatology, Gleneagles Global Health City, Perumbakkam, Chennai, Tamil Nadu, India, 600100

    Somashekara Hosaagrahara Ramakrishna

  2. Department of Pediatrics, Mazumdar Shaw Medical Centre, Narayana Health, Bangalore, Karnataka, India

    Samar Pratim Nayak

  3. Department of Pediatric Surgery and Division of Solid Organ Transplantation, Mazumdar Shaw Medical Centre, Narayana Health, Bangalore, Karnataka, India

    Sanjay Rao & Ashley Lucien Joseph D’Cruz

  4. Independent Statistical Researcher, Bangalore, Karnataka, India

    Mansi Garg

  5. Tejomir Diagnostics, Chennai, Tamil Nadu, India

    Kalyani Ramachandran

Authors
  1. Somashekara Hosaagrahara Ramakrishna
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  2. Samar Pratim Nayak
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  3. Sanjay Rao
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  4. Ashley Lucien Joseph D’Cruz
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  5. Mansi Garg
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  6. Kalyani Ramachandran
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Contributions

Contributors: HRS: conceptualized the study and edited the manuscript; SPM: data collection under supervision of HRS; SR: review of manuscript; ALD: review of manuscript; MG: primary analyses and interpretation of data; KR: conceptualized, drafted and edited the manuscript. All authors provided critical inputs into revision of the article and are willing to be accountable for all aspects of the study.

Corresponding author

Correspondence to Somashekara Hosaagrahara Ramakrishna.

Ethics declarations

Ethics clearance: IEC, Narayana Health Academic Ethics Committee; No. NHH/AEC-CL-2022-821 dated March 02, 2022.

Competing interests; None stated.

Additional information

Note: Additional material related to this study is available with the online version at https://www.indianpediatrics.net

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Ramakrishna, S.H., Nayak, S.P., Rao, S. et al. Kasai Portoenterostomy at a Slightly Delayed Age and Native Liver Survival in Children With Biliary Atresia: Single Center Experience. Indian Pediatr 60, 659–662 (2023). https://doi.org/10.1007/s13312-023-2967-1

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  • DOI: https://doi.org/10.1007/s13312-023-2967-1

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