Predictive values of liver FibroScan in postoperative biliary atresia

Abstract

Objective To explore the dynamic changes of liver stiffness measurement (LSM) in postoperative biliary atresia (BA) and examine the relationship between LSM and hematological indicators so as to provide rationales for prognostic assessment and sequential treatment of BA,Methods A retrospective analysis was conducted for LSM and hematological indicators of 85 BA patients from May 2012 to March 2013.LSM and hematological indicators were measured on the same day with 224 statistics available.And liver stiffness was evaluated by transient elastography (FibroScan).The hematological indicators included platelet (PLT),albumin (ALB),alkaline phosphatase (ALP),alanine aminotransferase (ALT),aspartate aminotransferase (AST),y glutamyltranspeptidase (GGT),total bilirubin (TBIL) and total bile acid (TBA).According to the time sequence of inspection,224 statistics were divided into 12 groups.Results LSM was positively correlated with ALP,AST,GGT,TBIL and TBA (r =0.391,0.171,0.243,0.194,0.327 respectively,all P＜0.01) and negatively correlated with PLT and ALB (r =0.267,0.249 respectively,both P＜0.01).In postoperative BA,LSM rose initially,peaked within 3 months and gradually decreased until 18 months.Then it stabilized at this level.The serum changes of postoperative ALT and LSM were basically identical.Both TBIL and LSM peaked within 3 months.LSM within 3 months was different from the other groups (all P＜0.01).Among 224 statistics,4 out of 5 LSM maximum at 75.0 kPa appeared within 3 months.And 2 children died from cholangitis and/ or refractory ascites at 6 and 8 months respectively.Conclusions In postoperative BA,LSM undergoes dynamic changes and it is closely correlated with hepatocytic damage and hepatic fibrosis.The serum levels of ALT and TBIL may affect the accuracy of LSM evaluation for liver fibrosis.LSM peaks at 3 months and a higher LSM at that time may portend a poor prognosis. Key words: Biliary atresia; Liver cirrhosis; Transient elastography