title: Galactose half-life is a useful tool in assessing prognosis of chronic liver disease in children.
abstract: In children, optimal timing of liver transplantation (LT) is crucial, but reliable prognostic tools for chronic liver diseases are scarce. We assessed the predictive value of galactose half-life (Gal½) for LT or death. A retrospective search of hospital database 2003-2010 revealed 92 consecutive children with chronic liver disease (36 biliary atresia) whose liver function was assessed with Gal½ measurement. Gal½, follow-up data, and liver biochemistry were recorded and pediatric/model for end-stage liver disease (P/MELD) scores calculated. Patients listed for LT or those who died within 1 year of the Gal½ measurement (Group 1) were compared to those surviving without listing (Group 2). Predictive value of Gal½ and P/MELD for listing for LT was assessed with area under the receiver operating characteristic curve (AUROC) analysis. Group 1 had markedly increased median Gal½ [17.0 (interquartile range 12.5-28.5) min] and higher P/MELD [13 (-1-23)] compared with group 2, [10.5 (9.5-12.5) min and -1 (-8-8); P < 0.001 for both]. Both Gal½ and P/MELD (P < 0.001) predicted listing or death with respective AUROCs of 0.808 (95% CI 0.704-0.913) and 0.780 (0.676-0.890), and 85% sensitivity and 69% specificity for Gal½≥12.0 min. Gal½ is a useful tool when evaluating 1-year prognosis in children with chronic liver disease.
authors: Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland. hanna.lampela@hus.fi
authors: Hanna
authors: H
authors: Lampela
authors: Silja
authors: S
authors: Kosola
authors: Hannu
authors: H
authors: Jalanko
authors: Mikko P
authors: MP
authors: Pakarinen
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D005690:Galactose / Q000493:pharmacokinetics*; D006801:Humans; D007223:Infant; D017093:Liver Failure / Q000628:therapy; D016031:Liver Transplantation / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D005690:Galactose