The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study
Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai po...
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| Vydáno v: | Pediatric surgery international Ročník 38; číslo 2; s. 193 - 199 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Berlin/Heidelberg
Springer Berlin Heidelberg
01.02.2022
Springer Nature B.V |
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| ISSN: | 0179-0358, 1437-9813, 1437-9813 |
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| Abstract | Purpose
The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.
Methods
A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.
Results
Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99).
Conclusion
Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. |
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| AbstractList | PurposeThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.MethodsA multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.ResultsOverall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99).ConclusionEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.PURPOSEThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.A multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.METHODSA multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance.Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99).RESULTSOverall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99).Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes.CONCLUSIONEarlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. A multi-institutional, retrospective cohort study was performed at nine tertiary-level children's hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance. Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97-0.99). Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. Purpose The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. Methods A multi-institutional, retrospective cohort study was performed at nine tertiary-level children’s hospitals in the United States. Infants who underwent Kasai portoenterostomy (KP) from January 2009 to May 2017 were identified. Clinical characteristics included age at time of KP, steroid use, surgical approach, liver pathology, and surgeon experience. Likelihood of transplant-free survival (TFS) was evaluated using logistic regression, adjusting for patient and surgeon-level factors. Secondary outcomes at 1 year included readmission, cholangitis, reoperation, mortality, and biliary clearance. Results Overall, 223 infants underwent KP, and 91 (40.8%) survived with their native liver. Mean age at surgery was 63.9 days (± 24.7 days). At 1 year, 78.5% experienced readmission, 56.9% developed cholangitis, 3.8% had a surgical revision, and 5 died. Biliary clearance at 3 months was achieved in 76.6%. Controlling for patient and surgeon-level factors, each additional day of age toward operation was associated with a 2% decrease in likelihood of TFS (OR 0.98, 95% CI 0.97–0.99). Conclusion Earlier surgical intervention by Kasai portoenterostomy at tertiary-level centers significantly increases likelihood for TFS. Policy-level interventions to facilitate early screening and surgical referral for infants with biliary atresia are warranted to improve outcomes. |
| Author | Im, Cecilia Inge, Thomas Ostlie, Daniel J. Smith, Caitlin Azarow, Kenneth S. Ourshalimian, Shadassa Nijagal, Amar Kling, Karen Mahdi, Elaa Shew, Stephen B. Shue, Eveline Wang, Kasper Dellinger, Matthew Lee, Justin Burke, Rita V. Fenlon, Michael Marwan, Ahmed I. Kelley-Quon, Lorraine I. Roach, Jonathan Ignacio, Romeo Russell, Katie W. Fialkowski, Elizabeth Padilla, Benjamin |
| AuthorAffiliation | e Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA a Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA i Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR d Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine, San Diego, CA h Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital, Salt Lake City, UT j Division of Pediatric Surgery, University of California, San Francisco, San Francisco, CA g Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado, Aurora, CO c Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, Seattle WA and Department of Surgery, University of Washington School of Medicine, Seattle, WA b Department |
| AuthorAffiliation_xml | – name: c Division of Pediatric General and Thoracic Surgery, Seattle Children’s Hospital, Seattle WA and Department of Surgery, University of Washington School of Medicine, Seattle, WA – name: f Division of Surgery, Phoenix Children’s Hospital, Phoenix, AZ – name: h Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital, Salt Lake City, UT – name: b Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA – name: d Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine, San Diego, CA – name: e Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA – name: g Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado, Aurora, CO – name: j Division of Pediatric Surgery, University of California, San Francisco, San Francisco, CA – name: i Division of Pediatric Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR – name: a Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California, Los Angeles, CA |
| Author_xml | – sequence: 1 givenname: Lorraine I. orcidid: 0000-0002-1735-0897 surname: Kelley-Quon fullname: Kelley-Quon, Lorraine I. email: lkquon@chla.usc.edu organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California – sequence: 2 givenname: Eveline surname: Shue fullname: Shue, Eveline organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 3 givenname: Rita V. surname: Burke fullname: Burke, Rita V. organization: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California – sequence: 4 givenname: Caitlin surname: Smith fullname: Smith, Caitlin organization: Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children’s Hospital, University of Washington School of Medicine – sequence: 5 givenname: Karen surname: Kling fullname: Kling, Karen organization: Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine – sequence: 6 givenname: Elaa surname: Mahdi fullname: Mahdi, Elaa organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 7 givenname: Shadassa surname: Ourshalimian fullname: Ourshalimian, Shadassa organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 8 givenname: Michael surname: Fenlon fullname: Fenlon, Michael organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California – sequence: 9 givenname: Matthew surname: Dellinger fullname: Dellinger, Matthew organization: Division of Pediatric General and Thoracic Surgery, Department of Surgery, Seattle Children’s Hospital, University of Washington School of Medicine – sequence: 10 givenname: Stephen B. surname: Shew fullname: Shew, Stephen B. organization: Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine – sequence: 11 givenname: Justin surname: Lee fullname: Lee, Justin organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 12 givenname: Benjamin surname: Padilla fullname: Padilla, Benjamin organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 13 givenname: Thomas surname: Inge fullname: Inge, Thomas organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 14 givenname: Jonathan surname: Roach fullname: Roach, Jonathan organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 15 givenname: Ahmed I. surname: Marwan fullname: Marwan, Ahmed I. organization: Department of Surgery, University of Colorado Denver School of Medicine and Children’s Hospital of Colorado – sequence: 16 givenname: Katie W. surname: Russell fullname: Russell, Katie W. organization: Division of Pediatric Surgery, University of Utah and Primary Children’s Hospital – sequence: 17 givenname: Romeo surname: Ignacio fullname: Ignacio, Romeo organization: Department of Pediatric Surgery, Rady Children’s Hospital San Diego, University of California School of Medicine – sequence: 18 givenname: Elizabeth surname: Fialkowski fullname: Fialkowski, Elizabeth organization: Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University – sequence: 19 givenname: Amar surname: Nijagal fullname: Nijagal, Amar organization: Division of Pediatric Surgery, University of California – sequence: 20 givenname: Cecilia surname: Im fullname: Im, Cecilia organization: Division of Pediatric Surgery, University of California – sequence: 21 givenname: Kenneth S. surname: Azarow fullname: Azarow, Kenneth S. organization: Division of Pediatric Surgery, Department of Surgery, Oregon Health and Science University – sequence: 22 givenname: Daniel J. surname: Ostlie fullname: Ostlie, Daniel J. organization: Division of Surgery, Phoenix Children’s Hospital – sequence: 23 givenname: Kasper surname: Wang fullname: Wang, Kasper organization: Division of Pediatric Surgery, Children’s Hospital Los Angeles and the Keck School of Medicine, University of Southern California |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34854975$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/s0140-6736(09)60946-6 10.1016/j.jhep.2019.03.005 10.1186/s12887-018-1074-2 10.1097/MOP.0000000000000214 10.1016/j.jpedsurg.2018.09.025 10.1016/j.jhep.2013.01.040 10.1097/mpg.0b013e3181d67e5e 10.1016/j.jpedsurg.2011.04.013 10.1001/jama.2020.0837 10.1542/peds.2007-2709 10.1542/peds.2008-1949 10.1016/j.ejso.2016.06.392 10.1016/S0140-6736(99)03492-3 10.1016/j.jpedsurg.2021.02.027 10.1016/j.jamcollsurg.2017.09.009 10.1097/SLA.0b013e3182300950 10.1007/s11605-013-2422-z 10.1016/j.jpeds.2017.05.006 10.1016/j.amjsurg.2015.08.021 10.1002/lt.24640 10.1097/mpg.0000000000002446 |
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| Keywords | Liver transplant Kasai portoenterostomy Biliary atresia Transplant-free survival |
| Language | English |
| License | 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Author Contributions: All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Lorraine Kelley-Quon, Rita Burke, Elaa Mahdi, and Shadassa Ourshalimian. The first draft of the manuscript was written by Lorraine Kelley-Quon and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. |
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| References | Fanna, Masson, Capito (CR7) 2019; 69 Harpavat, Garcia-Prats, Anaya (CR6) 2020; 323 Wadhwani, Turmelle, Nagy, Lowell, Dillon, Shepherd (CR8) 2008; 121 Hartley, Davenport, Kelly (CR2) 2009; 374 Al-Qurayshi, Robins, Buell, Kandil (CR18) 2016; 42 Enomoto, Gusani, Dillon, Hollenbeak (CR20) 2013; 18 Hukkinen, Kerola, Lohi (CR16) 2018; 226 Lai, Chen, Chen, Hung, Chang (CR12) 2006; 29 Toomey, Teta, Patel, Ross, Rosemurgy (CR19) 2016; 211 Serinet, Wildhaber, Broue (CR5) 2009; 123 Chen, Lin, Tsan (CR11) 2018; 18 Sundaram, Mack, Feldman, Sokol (CR21) 2017; 23 McKiernan, Baker, Kelly (CR14) 2000; 355 Superina, Magee, Brandt (CR1) 2011; 254 Zagory, Nguyen, Wang (CR4) 2015; 27 Davenport, Ong, Sharif (CR15) 2011; 46 Apfeld, Cooper, Sebastião, Tiao, Minneci, Deans (CR22) 2021; 56 Chardot, Buet, Serinet (CR10) 2013; 58 Jain, Burford, Alexander (CR13) 2019; 71 Hopkins, Yazigi, Nylund (CR3) 2017; 187 Wang, Chen, Peng (CR9) 2019; 54 Schreiber, Barker, Roberts, Martin (CR17) 2010; 51 R Superina (5047_CR1) 2011; 254 LM Enomoto (5047_CR20) 2013; 18 C Chardot (5047_CR10) 2013; 58 M-O Serinet (5047_CR5) 2009; 123 PJ McKiernan (5047_CR14) 2000; 355 SS Sundaram (5047_CR21) 2017; 23 RA Schreiber (5047_CR17) 2010; 51 S-Y Chen (5047_CR11) 2018; 18 S Harpavat (5047_CR6) 2020; 323 JC Apfeld (5047_CR22) 2021; 56 M Fanna (5047_CR7) 2019; 69 Z Wang (5047_CR9) 2019; 54 PG Toomey (5047_CR19) 2016; 211 JL Hartley (5047_CR2) 2009; 374 V Jain (5047_CR13) 2019; 71 SI Wadhwani (5047_CR8) 2008; 121 M Davenport (5047_CR15) 2011; 46 JA Zagory (5047_CR4) 2015; 27 Z Al-Qurayshi (5047_CR18) 2016; 42 H-S Lai (5047_CR12) 2006; 29 M Hukkinen (5047_CR16) 2018; 226 PC Hopkins (5047_CR3) 2017; 187 |
| References_xml | – volume: 374 start-page: 1704 issue: 9702 year: 2009 end-page: 1713 ident: CR2 article-title: Biliary atresia publication-title: Lancet doi: 10.1016/s0140-6736(09)60946-6 – volume: 71 start-page: 71 issue: 1 year: 2019 end-page: 77 ident: CR13 article-title: Prognostic markers at adolescence in patients requiring liver transplantation for biliary atresia in adulthood publication-title: J Hepatol doi: 10.1016/j.jhep.2019.03.005 – volume: 18 start-page: 119 issue: 1 year: 2018 ident: CR11 article-title: Number of cholangitis episodes as a prognostic marker to predict timing of liver transplantation in biliary atresia patients after Kasai portoenterostomy publication-title: BMC Pediatr doi: 10.1186/s12887-018-1074-2 – volume: 27 start-page: 389 issue: 3 year: 2015 end-page: 394 ident: CR4 article-title: Recent advances in the pathogenesis and management of biliary atresia publication-title: Curr Opin Pediatr doi: 10.1097/MOP.0000000000000214 – volume: 54 start-page: 1680 issue: 8 year: 2019 end-page: 1685 ident: CR9 article-title: Five-year native liver survival analysis in biliary atresia from a single large Chinese center: the death/liver transplantation hazard change and the importance of rapid early clearance of jaundice publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2018.09.025 – volume: 58 start-page: 1209 issue: 6 year: 2013 end-page: 1217 ident: CR10 article-title: Improving outcomes of biliary atresia: French national series 1986–2009 publication-title: J Hepatol doi: 10.1016/j.jhep.2013.01.040 – volume: 51 start-page: 61 issue: 1 year: 2010 end-page: 65 ident: CR17 article-title: Biliary atresia in Canada: the effect of centre caseload experience on outcome publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0b013e3181d67e5e – volume: 46 start-page: 1689 issue: 9 year: 2011 end-page: 1694 ident: CR15 article-title: Biliary atresia in England and Wales: results of centralization and new benchmark publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2011.04.013 – volume: 323 start-page: 1141 issue: 12 year: 2020 end-page: 1150 ident: CR6 article-title: Diagnostic yield of newborn screening for biliary atresia using direct or conjugated bilirubin measurements publication-title: JAMA doi: 10.1001/jama.2020.0837 – volume: 121 start-page: e1438LP issue: 5 year: 2008 end-page: e1440 ident: CR8 article-title: Prolonged neonatal jaundice and the diagnosis of biliary atresia: a single-center analysis of trends in age at diagnosis and outcomes publication-title: Pediatrics doi: 10.1542/peds.2007-2709 – volume: 123 start-page: 1280 issue: 5 year: 2009 end-page: 1286 ident: CR5 article-title: Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening publication-title: Pediatrics doi: 10.1542/peds.2008-1949 – volume: 42 start-page: 1483 issue: 10 year: 2016 end-page: 1490 ident: CR18 article-title: Surgeon volume impact on outcomes and cost of adrenal surgeries publication-title: Eur J Surg Oncol doi: 10.1016/j.ejso.2016.06.392 – volume: 355 start-page: 25 issue: 9197 year: 2000 end-page: 29 ident: CR14 article-title: The frequency and outcome of biliary atresia in the UK and Ireland publication-title: Lancet (London, England) doi: 10.1016/S0140-6736(99)03492-3 – volume: 56 start-page: 1196 issue: 6 year: 2021 end-page: 1202 ident: CR22 article-title: Variability in age at Kasai portoenterostomy for biliary atresia across US children’s hospitals publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2021.02.027 – volume: 226 start-page: 46 issue: 1 year: 2018 end-page: 57.e1 ident: CR16 article-title: Treatment policy and liver histopathology predict biliary atresia outcomes: results after national centralization and protocol biopsies publication-title: J Am Coll Surg doi: 10.1016/j.jamcollsurg.2017.09.009 – volume: 254 start-page: 577 issue: 4 year: 2011 end-page: 585 ident: CR1 article-title: The anatomic pattern of biliary atresia identified at time of Kasai hepatoportoenterostomy and early postoperative clearance of jaundice are significant predictors of transplant-free survival publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182300950 – volume: 18 start-page: 690 issue: 4 year: 2013 end-page: 700 ident: CR20 article-title: Impact of surgeon and hospital volume on mortality, length of stay, and cost of pancreaticoduodenectomy publication-title: J Gastrointest Surg doi: 10.1007/s11605-013-2422-z – volume: 187 start-page: 253 year: 2017 end-page: 257 ident: CR3 article-title: Incidence of biliary atresia and timing of hepatoportoenterostomy in the United States publication-title: J Pediatr doi: 10.1016/j.jpeds.2017.05.006 – volume: 211 start-page: 59 issue: 1 year: 2016 end-page: 63 ident: CR19 article-title: High-volume surgeons vs high-volume hospitals: are best outcomes more due to who or where? publication-title: Am J Surg doi: 10.1016/j.amjsurg.2015.08.021 – volume: 23 start-page: 96 issue: 1 year: 2017 end-page: 109 ident: CR21 article-title: Biliary atresia: indications and timing of liver transplantation and optimization of pretransplant care publication-title: Liver Transpl doi: 10.1002/lt.24640 – volume: 69 start-page: 416 issue: 4 year: 2019 end-page: 424 ident: CR7 article-title: Management of biliary atresia in France 1986 to 2015: long-term results publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0000000000002446 – volume: 29 start-page: 234 issue: 3 year: 2006 end-page: 239 ident: CR12 article-title: Long-term prognosis and factors affecting biliary atresia from experience over a 25 year period publication-title: Chang Gung Med J – volume: 42 start-page: 1483 issue: 10 year: 2016 ident: 5047_CR18 publication-title: Eur J Surg Oncol doi: 10.1016/j.ejso.2016.06.392 – volume: 58 start-page: 1209 issue: 6 year: 2013 ident: 5047_CR10 publication-title: J Hepatol doi: 10.1016/j.jhep.2013.01.040 – volume: 29 start-page: 234 issue: 3 year: 2006 ident: 5047_CR12 publication-title: Chang Gung Med J – volume: 69 start-page: 416 issue: 4 year: 2019 ident: 5047_CR7 publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0000000000002446 – volume: 374 start-page: 1704 issue: 9702 year: 2009 ident: 5047_CR2 publication-title: Lancet doi: 10.1016/s0140-6736(09)60946-6 – volume: 254 start-page: 577 issue: 4 year: 2011 ident: 5047_CR1 publication-title: Ann Surg doi: 10.1097/SLA.0b013e3182300950 – volume: 226 start-page: 46 issue: 1 year: 2018 ident: 5047_CR16 publication-title: J Am Coll Surg doi: 10.1016/j.jamcollsurg.2017.09.009 – volume: 18 start-page: 119 issue: 1 year: 2018 ident: 5047_CR11 publication-title: BMC Pediatr doi: 10.1186/s12887-018-1074-2 – volume: 323 start-page: 1141 issue: 12 year: 2020 ident: 5047_CR6 publication-title: JAMA doi: 10.1001/jama.2020.0837 – volume: 23 start-page: 96 issue: 1 year: 2017 ident: 5047_CR21 publication-title: Liver Transpl doi: 10.1002/lt.24640 – volume: 18 start-page: 690 issue: 4 year: 2013 ident: 5047_CR20 publication-title: J Gastrointest Surg doi: 10.1007/s11605-013-2422-z – volume: 123 start-page: 1280 issue: 5 year: 2009 ident: 5047_CR5 publication-title: Pediatrics doi: 10.1542/peds.2008-1949 – volume: 54 start-page: 1680 issue: 8 year: 2019 ident: 5047_CR9 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2018.09.025 – volume: 56 start-page: 1196 issue: 6 year: 2021 ident: 5047_CR22 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2021.02.027 – volume: 187 start-page: 253 year: 2017 ident: 5047_CR3 publication-title: J Pediatr doi: 10.1016/j.jpeds.2017.05.006 – volume: 355 start-page: 25 issue: 9197 year: 2000 ident: 5047_CR14 publication-title: Lancet (London, England) doi: 10.1016/S0140-6736(99)03492-3 – volume: 211 start-page: 59 issue: 1 year: 2016 ident: 5047_CR19 publication-title: Am J Surg doi: 10.1016/j.amjsurg.2015.08.021 – volume: 51 start-page: 61 issue: 1 year: 2010 ident: 5047_CR17 publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/mpg.0b013e3181d67e5e – volume: 121 start-page: e1438LP issue: 5 year: 2008 ident: 5047_CR8 publication-title: Pediatrics doi: 10.1542/peds.2007-2709 – volume: 27 start-page: 389 issue: 3 year: 2015 ident: 5047_CR4 publication-title: Curr Opin Pediatr doi: 10.1097/MOP.0000000000000214 – volume: 71 start-page: 71 issue: 1 year: 2019 ident: 5047_CR13 publication-title: J Hepatol doi: 10.1016/j.jhep.2019.03.005 – volume: 46 start-page: 1689 issue: 9 year: 2011 ident: 5047_CR15 publication-title: J Pediatr Surg doi: 10.1016/j.jpedsurg.2011.04.013 |
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The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.
Methods
A... The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia. A multi-institutional,... PurposeThe purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.MethodsA multi-institutional,... The purpose of this study was to investigate factors impacting transplant-free survival among infants with biliary atresia.PURPOSEThe purpose of this study was... |
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| SubjectTerms | Age Biliary Atresia - surgery Cholangitis Consortia Health Insurance Portability & Accountability Act 1996-US Hospitals Humans Infant Liver Transplantation Liver transplants Medical prognosis Medicine Medicine & Public Health Mortality Original Article Pediatric Surgery Pediatrics Portoenterostomy, Hepatic Retrospective Studies Steroids Surgery Thoracic surgery Treatment Outcome Variables |
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| Title | The need for early Kasai portoenterostomy: a Western Pediatric Surgery Research Consortium study |
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