Predictors of outcome among children with biliary atresia: a single centre trial

Objective This study aimed to investigate the predictive role of preoperative gamma-glutamyl transpeptidase (GGT) levels on the prognosis of neonatal biliary atresia (NBA) in patients who underwent the Kasai procedure. Methods A retrospective analysis was conducted of patients with NBA who underwent...

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Main Authors: Chaoxiang Ye, Wei Gao
Format: Article
Language:English
Published: PeerJ Inc. 2025-02-01
Series:PeerJ
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Online Access:https://peerj.com/articles/19001.pdf
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author Chaoxiang Ye
Wei Gao
author_facet Chaoxiang Ye
Wei Gao
author_sort Chaoxiang Ye
collection DOAJ
description Objective This study aimed to investigate the predictive role of preoperative gamma-glutamyl transpeptidase (GGT) levels on the prognosis of neonatal biliary atresia (NBA) in patients who underwent the Kasai procedure. Methods A retrospective analysis was conducted of patients with NBA who underwent the Kasai procedure at our hospital from 2017 to 2021. Patients were categorized into high (GGT > 300 IU/L) and GGT inadequate (GGT ≤ 300 IU/L) groups based on preoperative GGT levels. The influence of GGT levels on NBA prognosis was evaluated by comparing clinical data, age at operation, jaundice normalization, and survival outcomes between the groups. Results A total of 74 patients with NBA were included, with 59 in the high GGT group and 15 in the GGT inadequate group. Ages at the time of the Kasai procedure ranged from 31 to 106 days, with a median of 61 days; the average weight was 4.8 ± 1.1 kg. Two years post-procedure, 56 patients (75.7%) survived with their native liver (P < 0.0001). At 3 months post-procedure, alanine aminotransferase (ALT) levels were significantly higher in the GGT inadequate group compared to the high GGT group (3.5 times vs. 2.3 times the upper limit of normal, P = 0.0259). Significant differences in GGT levels persisted 1-month post-procedure (P = 0.0473). Jaundice clearance was significantly higher in the high GTT group (P = 0.0171) after 6 months. Multivariate logistic regression indicated a substantially higher mortality rate in the GGT inadequate group (P = 0.0452), with no significant age difference at operation (P = 0.8449). Preoperative GGT is a valuable predictor for NBA prognosis (area under the curve (AUC) 0.754, 95% confidence interval CI [0.640–0.847], P = 0.001, specificity 91.1%, and sensitivity 61.1%). Conclusions High preoperative GGT levels predict better prognosis in patients with NBA undergoing Kasai operation.
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spelling doaj-art-d703a453a98f4ed294c9e8ade1d99cca2025-08-20T02:04:19ZengPeerJ Inc.PeerJ2167-83592025-02-0113e1900110.7717/peerj.19001Predictors of outcome among children with biliary atresia: a single centre trialChaoxiang YeWei GaoObjective This study aimed to investigate the predictive role of preoperative gamma-glutamyl transpeptidase (GGT) levels on the prognosis of neonatal biliary atresia (NBA) in patients who underwent the Kasai procedure. Methods A retrospective analysis was conducted of patients with NBA who underwent the Kasai procedure at our hospital from 2017 to 2021. Patients were categorized into high (GGT > 300 IU/L) and GGT inadequate (GGT ≤ 300 IU/L) groups based on preoperative GGT levels. The influence of GGT levels on NBA prognosis was evaluated by comparing clinical data, age at operation, jaundice normalization, and survival outcomes between the groups. Results A total of 74 patients with NBA were included, with 59 in the high GGT group and 15 in the GGT inadequate group. Ages at the time of the Kasai procedure ranged from 31 to 106 days, with a median of 61 days; the average weight was 4.8 ± 1.1 kg. Two years post-procedure, 56 patients (75.7%) survived with their native liver (P < 0.0001). At 3 months post-procedure, alanine aminotransferase (ALT) levels were significantly higher in the GGT inadequate group compared to the high GGT group (3.5 times vs. 2.3 times the upper limit of normal, P = 0.0259). Significant differences in GGT levels persisted 1-month post-procedure (P = 0.0473). Jaundice clearance was significantly higher in the high GTT group (P = 0.0171) after 6 months. Multivariate logistic regression indicated a substantially higher mortality rate in the GGT inadequate group (P = 0.0452), with no significant age difference at operation (P = 0.8449). Preoperative GGT is a valuable predictor for NBA prognosis (area under the curve (AUC) 0.754, 95% confidence interval CI [0.640–0.847], P = 0.001, specificity 91.1%, and sensitivity 61.1%). Conclusions High preoperative GGT levels predict better prognosis in patients with NBA undergoing Kasai operation.https://peerj.com/articles/19001.pdfNeonatal biliary atresiaGamma-glutamyl transferaseKasai procedure
spellingShingle Chaoxiang Ye
Wei Gao
Predictors of outcome among children with biliary atresia: a single centre trial
PeerJ
Neonatal biliary atresia
Gamma-glutamyl transferase
Kasai procedure
title Predictors of outcome among children with biliary atresia: a single centre trial
title_full Predictors of outcome among children with biliary atresia: a single centre trial
title_fullStr Predictors of outcome among children with biliary atresia: a single centre trial
title_full_unstemmed Predictors of outcome among children with biliary atresia: a single centre trial
title_short Predictors of outcome among children with biliary atresia: a single centre trial
title_sort predictors of outcome among children with biliary atresia a single centre trial
topic Neonatal biliary atresia
Gamma-glutamyl transferase
Kasai procedure
url https://peerj.com/articles/19001.pdf
work_keys_str_mv AT chaoxiangye predictorsofoutcomeamongchildrenwithbiliaryatresiaasinglecentretrial
AT weigao predictorsofoutcomeamongchildrenwithbiliaryatresiaasinglecentretrial