Relationship between Preoperative Aspartate Aminotransferase-To-Platelet Ratio Index (APRI) and Gamma Glutamyl Transpeptidase (GGT) With Early Postoperative Jaundice Clearance and Native Liver Survival in Biliary Atresia

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Purpose: The purpose of this study was to observe the relationship between Preoperative Aspertate Aminotransferase to Platelet Ratio Index (APRI) and Gamma-Glut amyl Transpeptidase (GGT) with early postoperative jaundice clearance and native liver survival that were operated in this institution. This study will help to identify the children who are likely candidates for early liver transplantation. Methods: This Observational Longitudinal study was conducted in the Department of Paediatric Surgery, BSMMU with the study period of24 months. Total 25 patients of biliary atresia were included in this study. 3 patients were excluded for death in early post operative period. All the patients were categorized according to age at operation as Group A(<60 days), Group B(61-90 days), Group C(>90 days). Measurement of serum bilirubin, Gamma-glutamyl transpeptidase (GGT), Aspertate aminotransferase to platelet ratio index (APRI)was done in preoperative and postoperative period (at 14-day, 1 month, 3 month and 6 month). Results: Total 3 patients were in Group A, 11 in Group B, 8 in Group C. Mean age atoperation was 86.2(±18.8SD) days and range was 57days to 140 days. Total 10 (45.5%) patient was jaundice free at 3 months after extended KPE and they were also remained jaundice free at 6 months while 12 (54.5%) patients had persistent jaundice. Mean preoperative Gamma-Glutamyl Transpeptidase (GGT) in persistent jaundice group was1208.42 (±855.82 SD) U/L and at 6 month after operation it was 711.3(±446.4 SD) U/L while in Jaundice free group preoperative Gamma-Glutamyl Transpeptidase (GGT) value was 900.40(±582.81SD) U/L and 6 month after operation it was 213.1(±89.1SD), (P=0.003) which is statistically significant. Mean preoperative APRI in persistent jaundice was1.95 (±1.52SD) and at 6 month it was 1.22(±0.53SD) while in Jaundice free group preoperative value was 1.10(±0.54SD) and 6 month of operation it was 0.39(±0.14SD), (P=0.004) which is statistically significant. ...