title: Early and Peri-operative Prognostic Indicators in Infants Undergoing Hepatic Portoenterostomy for Biliary Atresia: a Review.
abstract: OBJECTIVE
  Biliary atresia is the most common indication for liver transplantation among children. In recent years, prospective, multi-centre collaboration has been underway with the aim of providing high-quality data on the natural history of the condition, prior to and following hepatic portoenterostomy.
  
  
  RESULTS
  There is increasing evidence that specific histological findings, and age, at the time of portoenterostomy have relevance as prognostic indicators. Recent data suggest that the sub-type of biliary atresia, its co-existence with other anomalies and concurrent infection may also be important variables. This review provides a comprehensive summary of the histological predictors of outcome following portoenterostomy. Later age at portoenterostomy, advanced degree of hepatic fibrosis and co-existence with other congenital anomalies are strongly correlated with poor outcomes following portoenterostomy. There is increasing evidence to suggest that common serological indices and the presence or absence of cytomegalovirus (CMV) co-infection may have utility as early prognostic indicators.
authors.affiliation: Department of Gastroenterology, Sydney Children's Hospital, High Street, Randwick, Sydney, NSW 2031, Australia. Robert.Lopez@health.nsw.gov.au.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Lopez
authors.affiliation: Department of Gastroenterology, Sydney Children's Hospital, High Street, Randwick, Sydney, NSW 2031, Australia.|Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales, South Wales, Australia.
authors.forename: Chee Y
authors.initials: CY
authors.lastname: Ooi
authors.affiliation: Department of Gastroenterology, Sydney Children's Hospital, High Street, Randwick, Sydney, NSW 2031, Australia.|Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales, South Wales, Australia.
authors.forename: Usha
authors.initials: U
authors.lastname: Krishnan
mesh_terms: D000367:Age Factors; D001656:Biliary Atresia / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D003586:Cytomegalovirus Infections / Q000150:complications; D006801:Humans; D007223:Infant; D011171:Portoenterostomy, Hepatic; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: Atresia; Biliary; Histology; Kasai; Outcome; Predictors