Early cytomegalovirus infection and the long-term outcome of biliary atresia.
OBJECTIVE
To study the impact of ongoing cytomegalovirus (CMV) infection at presentation of biliary atresia (BA) on the long-term outcome after Kasai procedure.


METHODS
Twenty-eight patients with BA born 1988-1997 were included and followed-up until 2007. Eleven patients (group A) had ongoing CMV infection at presentation and were compared to the remaining 17 patients (group B). Median age at Kasai procedure was 75 days in group A and 70 days in group B (p = 0.12).


RESULTS
Including all patients, survival with native liver was 50% and 36% at 4 and 10 years of follow-up respectively. At the end of follow-up, it was 25% and overall survival was 68%. When comparing groups A and B, neither difference in survival with native liver (p = 0.67, log-rank test) nor in survival after liver transplantation was detected.


CONCLUSIONS
Survival with native liver after Kasai procedure is comparable to that of other centres. CMV positive patients may present with a later onset, alternatively the detection of CMV infection could delay the referral of BA patients. No significant differences in long-term outcome were detected with regard to early CMV infection.
Fischler
Björn
B
Department of Pediatrics, Karolinska University Hospital, CLINTEC, Karolinska Intitutet, Stockholm, Sweden. bjorn.fischler@karolinska.se
Svensson
Jan F
JF
Nemeth
Antal
A
D000293:Adolescent; D017668:Age of Onset; D001656:Biliary Atresia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D011171:Portoenterostomy, Hepatic / Q000401:mortality; D018709:Statistics, Nonparametric; D016896:Treatment Outcome