Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia

Objective: This study aimed to use transient elastography (TE) to evaluate the correlation between liver stiffness measure (LSM) and functional status of native liver in longterm follow-up of pediatric patients with biliary atresia (BA). Methods: Twenty cases of BA who had undergone hepatic portoent...

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Main Authors: Witsanee Srisuwan, Wison Laochareonsuk, Panu Wetwittayakhlang, Supika Kritsaneepaiboon, Surasak Sangkhathat
Format: Article
Language:English
Published: Mahidol University 2020-11-01
Series:Siriraj Medical Journal
Subjects:
Online Access:https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/243941
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spelling doaj-c700184f161d4d97a806b233a4d3f0402021-01-08T07:40:17ZengMahidol UniversitySiriraj Medical Journal0125-152X2228-80822020-11-017313237243941Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary AtresiaWitsanee Srisuwan0Wison Laochareonsuk1Panu Wetwittayakhlang2Supika Kritsaneepaiboon3Surasak Sangkhathat4Department of Surgery, Faculty of Medicine, Prince of Songkla UniversityDepartment of Surgery, Faculty of Medicine, Prince of Songkla UniversityDepartment of Internal Medicine, Faculty of Medicine, Prince of Songkla UniversityDepartment of Internal Medicine and NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla UniversityDepartment of Surgery, Faculty of Medicine, Prince of Songkla UniversityObjective: This study aimed to use transient elastography (TE) to evaluate the correlation between liver stiffness measure (LSM) and functional status of native liver in longterm follow-up of pediatric patients with biliary atresia (BA). Methods: Twenty cases of BA who had undergone hepatic portoenterostomy and had good initial outcome (total bilirubin < 2 mg/dL) were enrolled for a transient elastography. The LSMs derived from the study were analyzed with clinical and radiological parameters and endoscopic findings of esophageal varices.  Results: The median age at enrollment of the 20 cases was 8.4 years. Of the 20 cases, 15 were diagnosed as cirrhosis by ultrasonography and 9 had esophageal varices detected by an endoscopy. Parameters that were significantly associated with LSM were history of cholangitis, splenomegaly, cirrhosis and esophageal varices. Significantly higher LSM was found to be correlated with hyperbilirubinemia, transaminitis, alkaline phosphatasemia, thrombocytopenia and prolonged INR. On linear regression, LSM was significantly correlated with pediatric end-stage liver disease score at the r2 of 0.32 and correlated with the aspartate transaminase to platelet ratio index at the r2 of 0.70. The area under the receiver operating characteristic curve that reflected the performance of LSM in predicting esophageal varices was 0.97. At the cut-off value of 10.2 kPa, the sensitivity and specificity of LSM in predicting esophageal varices were 100% and 72.7%, respectively. Conclusion: TE can be useful as a non-invasive, point-of-care evaluation of liver fibrosis in long term follow-up of BA. A high LSM indicates surveillance for esophageal varices in these patients.https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/243941transient elastrographybiliary atresialiver stiffness measurement
collection DOAJ
language English
format Article
sources DOAJ
author Witsanee Srisuwan
Wison Laochareonsuk
Panu Wetwittayakhlang
Supika Kritsaneepaiboon
Surasak Sangkhathat
spellingShingle Witsanee Srisuwan
Wison Laochareonsuk
Panu Wetwittayakhlang
Supika Kritsaneepaiboon
Surasak Sangkhathat
Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
Siriraj Medical Journal
transient elastrography
biliary atresia
liver stiffness measurement
author_facet Witsanee Srisuwan
Wison Laochareonsuk
Panu Wetwittayakhlang
Supika Kritsaneepaiboon
Surasak Sangkhathat
author_sort Witsanee Srisuwan
title Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
title_short Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
title_full Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
title_fullStr Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
title_full_unstemmed Correlation of Transient Elastography and Progression of Cirrhosis in Longterm Survivors of Biliary Atresia
title_sort correlation of transient elastography and progression of cirrhosis in longterm survivors of biliary atresia
publisher Mahidol University
series Siriraj Medical Journal
issn 0125-152X
2228-8082
publishDate 2020-11-01
description Objective: This study aimed to use transient elastography (TE) to evaluate the correlation between liver stiffness measure (LSM) and functional status of native liver in longterm follow-up of pediatric patients with biliary atresia (BA). Methods: Twenty cases of BA who had undergone hepatic portoenterostomy and had good initial outcome (total bilirubin < 2 mg/dL) were enrolled for a transient elastography. The LSMs derived from the study were analyzed with clinical and radiological parameters and endoscopic findings of esophageal varices.  Results: The median age at enrollment of the 20 cases was 8.4 years. Of the 20 cases, 15 were diagnosed as cirrhosis by ultrasonography and 9 had esophageal varices detected by an endoscopy. Parameters that were significantly associated with LSM were history of cholangitis, splenomegaly, cirrhosis and esophageal varices. Significantly higher LSM was found to be correlated with hyperbilirubinemia, transaminitis, alkaline phosphatasemia, thrombocytopenia and prolonged INR. On linear regression, LSM was significantly correlated with pediatric end-stage liver disease score at the r2 of 0.32 and correlated with the aspartate transaminase to platelet ratio index at the r2 of 0.70. The area under the receiver operating characteristic curve that reflected the performance of LSM in predicting esophageal varices was 0.97. At the cut-off value of 10.2 kPa, the sensitivity and specificity of LSM in predicting esophageal varices were 100% and 72.7%, respectively. Conclusion: TE can be useful as a non-invasive, point-of-care evaluation of liver fibrosis in long term follow-up of BA. A high LSM indicates surveillance for esophageal varices in these patients.
topic transient elastrography
biliary atresia
liver stiffness measurement
url https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/243941
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