title: Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in Taiwan.
abstract: In Taiwan, a screening system using an infant stool color card to promote the early diagnosis of biliary atresia (BA) was established in 2002. This study aimed to investigate the 5-year outcome of BA before and after using the screening program. BA patients were divided into three cohorts according to their birth dates. The patients in cohort A (n = 89) were born before the stool card screening program (1990-2000); those in cohort B (n = 28) were screened by the stool card regional screening program (2002-2003); and those in cohort C (n = 74) were screened by the stool card universal screening program (2004-2005). The relative odds ratios were computed using logistic regression to compare the different factors affecting survival time. The rate of age at Kasai operation <60 days was 49.4% and 65.7% in cohorts A and B+C, respectively (P = 0.02). The jaundice-free (total serum bilirubin <2.0 mg/dL) rate 3 months after surgery was 34.8% and 60.8% in cohorts A and B+C, respectively (P < 0.001). The 3-year jaundice-free survival rate with native liver was 31.5% in cohort A and 56.9% in cohort B+C (P < 0.001), whereas the 3-year overall survival rates were 64.0% and 89.2%, respectively (P < 0.001). The 5-year jaundice-free survival rate with native liver was 27.3% in cohort A and 64.3% in cohort B (P < 0.001), and the 5-year overall survival rates were 55.7% and 89.3%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  The stool color card screening program for BA allows for earlier Kasai operation, which increases the jaundice-free rate at 3 months postsurgery. With higher surgical success rates, the 3- and 5-year outcome of BA patients in Taiwan improves remarkably.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tien-Hau
authors.initials: TH
authors.lastname: Lien
authors.forename: Mei-Hwei
authors.initials: MH
authors.lastname: Chang
authors.forename: Jia-Feng
authors.initials: JF
authors.lastname: Wu
authors.forename: Huey-Ling
authors.initials: HL
authors.lastname: Chen
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Lee
authors.forename: An-Chyi
authors.initials: AC
authors.lastname: Chen
authors.forename: Mao-Meng
authors.initials: MM
authors.lastname: Tiao
authors.forename: Tzee-Chung
authors.initials: TC
authors.lastname: Wu
authors.forename: Yao-Jong
authors.initials: YJ
authors.lastname: Yang
authors.forename: Chieh-Chung
authors.initials: CC
authors.lastname: Lin
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lai
authors.forename: Hong-Yuan
authors.initials: HY
authors.lastname: Hsu
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Ni
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D015331:Cohort Studies; D003116:Color; D018572:Disease-Free Survival; D005243:Feces; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D011171:Portoenterostomy, Hepatic; D016896:Treatment Outcome