The limited prognostic value of liver histology in children with biliary atresia
Journal Title: Annals of Hepatology - Year 2015, Vol 14, Issue 6
Abstract
Background and rationale for the study. The aim of the study was to determine the prognostic value of histopathological findings with special care to the severity of liver fibrosis at the moment of hepatoportoenterostomy (HPE) in children with biliary atresia (BA). We performed analysis of 142 wedge liver biopsies taken at the time of HPE. All patients were operated by the same surgical team between 1995 and 2007. According to the outcome 6 months after HPE patients were divided into prognostic groups: group 1-bilirubin level < 2 mg% (n = 65), group 2-bilirubin level > 2 mg% (n = 77). Liver biopsies were re-evaluated according to the extended histopathological protocol and then were compared between the prognostic groups. Survival with native liver (SNL) estimates were performed in regard to severity of liver fibrosis. Results. Survival with native liver estimates after 2, 5 and 10 years in patients after successful operation were 96%, 91%, 75% vs. 30%, 11%, and 5% if operation failed (p < 0.001). There was no difference between groups in the following variables: fibrosis (p = 0.69), portal inflammation (p = 0.99), lobular inflammation (p = 0.95), cholangiolitis (p = 0.23), accumulation of bile pigments (zone 1:p = 0.49; zone 2:p = 0.51; zone 3:p = 0.48), bile plugs in canaliculi (p = 0.12), bile plugs in ducts (p = 0.32), bilirubinostasis in hepatocytes (p = 0.45), bile ductular proliferation (p = 0.59), ductal plate malformation (p = 0.12), focal necrosis (p = 0.44), giant cell transformation (p = 0.45), haematopoesis (p = 0.52), ductopenia (p = 0.46), microabscesses (p = 0.49), ballooning of hepatocytes (p = 0.08). The actuarial 5/10-year SNL was not dependent on severity of liver fibrosis (log-rank test p = 0.84). The severity of fibrosis corresponded neither with the age at HPE nor with the laboratory findings before operation but increased the risk of portal hypertension. Conclusion. Liver histology at the time of HPE is of limited value in prognosis making in BA.
Authors and Affiliations
Piotr Czubkowski, Joanna Cielecka-Kuszyk, Małgorzata Rurarz, Diana Kamińska
Keywords
Related Articles
- EP ID EP78521
- DOI 10.5604/16652681.1171781
- Views 104
- Downloads 0
Autoimmune hepatitis with giant-cell transformation
Background/Aims: Giant-cell hepatitis (GCH), also known as postinfantile or syncytial giant cell hepatitis, is a frequent pattern of liver injury in the neonate, primarily seen in the first three months of life. Few case...
Surgical morbidity in severely obese liver transplant recipients - A single Canadian Centre Experience
The prevalence of obesity is increasing globally, with nearly half of a billion of the world’s population now considered to be overweight or obese. Obesity and overweight patients are one of the major health issues in Ca...
Etiology, outcome and prognostic factors of childhood acute liver failure in a German Single Center
Pediatric acute liver failure (PALF) is a progressive, potentially fatal clinical syndrome occurring in previously healthy children. Our study aimed to determine the current leading causes of PALF in a single center in G...
XII NATIONAL MEETING OF THE MEXICAN ASSOCIATION OF HEPATOLOGY
-
Abnormal hepatic biochemistries and clinical liver disease in patients with primary Sjögren’s syndrome
Background/Aims: Patients with primary Sjögren’s syndrome may present liver involvement. Our goals were to establish the prevalence of abnormal hepatic biochemistries and clinical liver disease in patients with primary S...