Biomarkers of native liver survival and portal hypertension in biliary atresia
In brief
Three liver fibrosis measures tracked poorer native-liver survival after Kasai surgery
In this single-center retrospective study, higher AST-to-platelet ratio index, infantile biliary atresia liver fibrosis score, and biopsy fibrosis scores were associated with lower native-liver survival after Kasai surgery. The two blood-based scores also predicted portal hypertension, suggesting a role in follow-up risk assessment; whether these markers improve decisions or outcomes needs further study.
- Journal
- Journal of pediatric gastroenterology and nutrition (Q1)
- Published
- 18 October 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Karyne Sumico de Lima Uyeno Jordão, Larissa Bastos Eloy da Costa, Maria Ângela Bellomo-Brandão
- PMID
- 42893939
- DOI
- 10.1002/jpn3.70618
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 19 October 2026): Biomarkers predict native liver survival after Kasai
Abstract
OBJECTIVE: To evaluate the prognostic value of noninvasive markers Aspartate Aminotransferase to Platelet Ratio Index (APRi) and Infantile Biliary Atresia Liver Fibrosis score (iBALF), as well as the histological Ishak fibrosis score, as predictors of native liver survival (NLS) and portal hypertension (PH) in children with biliary atresia BA undergoing Kasai portoenterostomy (KPE). METHODS: A single-center, retrospective observational study was conducted on children diagnosed with BA who underwent KPE. APRi and iBALF were calculated using laboratory data collected at hospital discharge after KPE. The degree of hepatic fibrosis was assessed and reviewed using the Ishak fibrosis score in liver biopsy specimens collected at KPE. NLS was analyzed using Kaplan-Meier survival curves and Cox proportional hazards regression. A p-value < 0.05 was considered statistically significant. RESULTS: Higher APRi, iBALF, and Ishak fibrosis score values were associated with lower NLS (p < 0.006, p < 0.025, and p < 0.048, respectively). APRi and iBALF emerged as good PH predictors (p < 0.005 and p < 0.032, respectively). CONCLUSION: APRi, iBALF, and the Ishak fibrosis score showed prognostic value in predicting NLS in children with BA after KPE. These findings reinforce the potential use of biomarkers in the clinical follow-up of these patients, supporting risk stratification strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.