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Quantitative Liver Fibrosis Using Collagen Hybridizing Peptide to Predict Native Liver Survival in Biliary Atresia: A Pilot Study
- Source :
- Journal of Pediatric Gastroenterology & Nutrition. 70:87-92
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background/rationale Biliary atresia (BA) is a cholangiopathy characterized by bile flow obstruction due to destruction of the biliary tree. Without surgical correction with Kasai portoenterostomy (KPE), BA leads to death or liver transplant (LTx). Early-onset, progressive liver fibrosis is a defining characteristic of BA. Collagen hybridizing peptide (CHP) is a synthetic peptide which binds to denatured collagen strands allowing quantification of fibrosis. This technique has not been used on human liver tissue. The aim of this pilot study was to evaluate the utility of CHP as a measurement of quantitative fibrosis to allow earlier survival with native liver prognostication. Results We identified 21 patients with wedge liver biopsies available, of which 14 required LTx. No deaths occurred. Patients requiring LTx tended to be girls with a significantly different mean bilirubin (P = 0.002), albumin (P = 0.001), and alanine aminotransferase (P = 0.03) at 3 months post-KPE. By 1 year post-KPE, 50% of patients in the high CHP intensity group required LTx versus 27% in the low CHP. Overall, fibrosis as quantified by CHP at time of KPE was associated with more than 3 times the risk of requiring LTx by 4 years of age (hazard ratio 3.6, 95% confidence interval 1.15-10.93, P = 0.03). When controlling for sex and total bilirubin >2 mg/dL and albumin at 3 months post-KPE, it predicted nearly 7 times the risk of LTx (hazard ratio 6.89, 95% confidence interval 1.38-34.32, P = 0.02). Conclusion Our results suggest that quantitative assessment of fibrosis at the time of KPE holds promise as an earlier predictor of LTx requirement in BA. A larger study is justified to assess quantitative fibrosis as a BA prognostic tool.
- Subjects :
- Liver Cirrhosis
Male
medicine.medical_specialty
Cirrhosis
Bilirubin
Biopsy
medicine.medical_treatment
Pilot Projects
Liver transplantation
Risk Assessment
Gastroenterology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Liver Function Tests
Cholestasis
Biliary Atresia
Predictive Value of Tests
Biliary atresia
Fibrosis
030225 pediatrics
Internal medicine
medicine
Humans
Proportional Hazards Models
Retrospective Studies
medicine.diagnostic_test
business.industry
Patient Selection
Hazard ratio
Infant
Reproducibility of Results
Prognosis
medicine.disease
Liver Transplantation
Liver
chemistry
Liver biopsy
Pediatrics, Perinatology and Child Health
Feasibility Studies
Female
030211 gastroenterology & hepatology
Collagen
Peptides
business
Subjects
Details
- ISSN :
- 15364801 and 02772116
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Gastroenterology & Nutrition
- Accession number :
- edsair.doi.dedup.....fb347a40f74da26a904314d6dce10ba5