title: PELD score and age as a prognostic index of biliary atresia patients undergoing Kasai portoenterostomy.
abstract: OBJECTIVE
  This study was designed to evaluate the validity of the pediatric end-stage liver disease (PELD) score as a prognostic index of native liver survival in biliary atresia before Kasai portoenterostomy.
  
  
  METHODS
  Medical records of 63 patients who underwent Kasai portoenterostomy at our hospital were reviewed retrospectively. Rate of jaundice clearance and cumulative survival with native liver were calculated. Patients who were alive and did not require transplantation until the last follow up were included in the native-liver survival group. And patients who underwent any event, defined as death without transplantation, transplantation or listing for transplantation, were included in the native-liver failure group. Cox analysis was done.
  
  
  RESULTS
  10-year survival rate with native liver was 41.9%. PELD scores of ≥ 15 and an age at operation of ≥ 60 days were found to be significant risk factors of failure(P = 0.007, OR = 2.851 and P = 0.010, OR = 3.222, respectively). Furthermore, patients with both risk factors showed significantly higher risk of failure (P = 0.001, OR = 8.809).
  
  
  CONCLUSIONS
  Since failure rate is higher for patients with high PELD score and older age, these factors should be helpful in estimating the prognosis. And with high-risk patients, cautious monitoring and consultation should be made whether the liver fails and requires transplantation.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea. jsrrules@gmail.com
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Rhu
authors.forename: Soo-Min
authors.initials: SM
authors.lastname: Jung
authors.forename: Yon Ho
authors.initials: YH
authors.lastname: Choe
authors.forename: Jeong-Meen
authors.initials: JM
authors.lastname: Seo
authors.forename: Suk-Koo
authors.initials: SK
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D001656:Biliary Atresia / Q000150:complications* / Q000601:surgery*; D058625:End Stage Liver Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies