Biliary Atresia: The Canadian Experience - 12/08/11
, Collin C. Barker, MSc(Epid), MD, FRCP(C) a, Eve A. Roberts, MD, FRCP(C) b, Steven R. Martin, MD, FRCP(C) c, Fernando Alvarez, MD c, Lesley Smith, MD, FRCP(C) d, J. Decker Butzner, MD, FRCP(C) e, Iwona Wrobel, MD, FRCP(C) e, David Mack, MD, FRCP(C) f, Stanley Moroz, MD, FRCP(C) g, Mohsin Rashid, MD, FRCP(C) h, Rabin Persad, MD, FRCP(C) i, Dominique Levesque, MD, FRCP(C) j, Herbert Brill, MD, FRCP(C) j, Garth Bruce, MD, FRCP(C) k, Jeff Critch, MD, FRCP(C) lCanadian Pediatric Hepatology Research Group
Reprint requests: Dr. Richard Schreiber, Clinical Professor of Pediatrics, University of British Columbia, Division of Gastroenterology, BC Children’s Hospital, Room K4-200, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4.Résumé |
Objective |
To determine the outcomes of Canadian children with biliary atresia.
Study design |
Health records of infants born in Canada between January 1, 1985 and December 31, 1995 (ERA I) and between January 1, 1996 and December 31, 2002 (ERA II) who were diagnosed with biliary atresia at a university center were reviewed.
Results |
349 patients were identified. Median patient age at time of the Kasai operation was 55 days. Median age at last follow-up was 70 months. The 4-year patient survival rate was 81% (ERA I = 74%; ERA II = 82%; P = not significant [NS]). Kaplan-Meier survival curves for patients undergoing the Kasai operation at age ≤30, 31 to 90, and >90 days showed 49%, 36%, and 23%, respectively, were alive with their native liver at 4 years (P < .0001). This difference continued through 10 years. The 2- and 4-year post-Kasai operation native liver survival rates were 47% and 35% for ERA I and 46% and 39% for ERA II (P = NS). A total of 210 patients (60%) underwent liver transplantation; the 4-year transplantation survival rate was 82% (ERA I = 83%, ERA II = 82%; P = NS).
Conclusions |
This is the largest outcome series of North American children with biliary atresia at a time when liver transplantation was available. Results in each era were similar. Late referral remains problematic; policies to ensure timely diagnosis are required. Nevertheless, outcomes in Canada are comparable to those reported elsewhere.
Le texte complet de cet article est disponible en PDF.Abbreviations : BASM
Plan
Vol 151 - N° 6
P. 659 - décembre 2007 Retour au numéro
Article précédent
- Glucose Tolerance, Insulin Secretion, and Insulin Sensitivity in Children and Adolescents with Cystic Fibrosis and No Prior History of Diabetes
- Deborah A. Elder, Jamie L. Wooldridge, Lawrence M. Dolan, David A. D’Alessio
- Constipation as Cause of Acute Abdominal Pain in Children
- Vera Loening-Baucke, Alexander Swidsinski
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?