Management of biliary atresia in france ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Management of biliary atresia in france 1986-2015: long term results
Auteur(s) :
Fanna, Martina [Auteur]
Masson, Guillaume [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Capito, Carmen [Auteur]
Girard, Muriel [Auteur]
Guerin, Florent [Auteur]
Hermeziu, Bogdan [Auteur]
Lachaux, Alain [Auteur]
Roquelaure, Bertrand [Auteur]
gottrand, Fréderic [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Broue, Pierre [Auteur]
Dabadie, Alain [Auteur]
Jacquemin, Emmanuel [Auteur]
Université Paris-Sud - Paris 11 [UP11]
Chardot, Christophe [Auteur]
Masson, Guillaume [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Capito, Carmen [Auteur]
Girard, Muriel [Auteur]
Guerin, Florent [Auteur]
Hermeziu, Bogdan [Auteur]
Lachaux, Alain [Auteur]
Roquelaure, Bertrand [Auteur]
gottrand, Fréderic [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Broue, Pierre [Auteur]
Dabadie, Alain [Auteur]
Jacquemin, Emmanuel [Auteur]
Université Paris-Sud - Paris 11 [UP11]
Chardot, Christophe [Auteur]
Titre de la revue :
Journal of Pediatric Gastroenterology and Nutrition
Nom court de la revue :
J. Pediatr. Gastroenterol. Nutr.
Numéro :
69
Pagination :
416-424
Date de publication :
2019-10
ISSN :
1536-4801
Mot(s)-clé(s) en anglais :
liver transplantation
prognosis
Kasai operation
biliary atresia
prognosis
Kasai operation
biliary atresia
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
This study analyses the prognosis of biliary atresia (BA) in France since 1986, when both Kasai operation (KOp) and liver transplantation (LT) became widely available.
The charts of all patients diagnosed with BA born ...
Lire la suite >This study analyses the prognosis of biliary atresia (BA) in France since 1986, when both Kasai operation (KOp) and liver transplantation (LT) became widely available. The charts of all patients diagnosed with BA born between 1986 and 2015 and living in France were reviewed. A total of 1428 patients were included; 1340 (94%) underwent KOp. Total clearance of jaundice (total bilirubin ≤20 μmol/L) was documented in 516 patients (39%). Age at KOp (median 59 days, range 6-199) was stable over time. Survival with native liver after KOp was 41%, 35%, 26%, and 22% at 5, 10, 20, and 30 years, stable in the 4 cohorts. 25-year survival with native liver was 38%, 27%, 22%, and 19% in patients operated in the first, second, third month of life or later, respectively (P = 0.0001). Center caseloads had a significant impact on results in the 1986 to 1996 cohort only. 16%, 7%, 7%, and 8% of patients died without LT in the 4 cohorts (P = 0.0001). A total of 753 patients (55%) underwent LT. Patient survival after LT was 79% at 28 years. Five-year patient survival after LT was 76%, 91%, 88%, and 92% in cohorts 1 to 4, respectively (P < 0.0001). Actual BA patient survival (from diagnosis) was 81%. Five-year BA patient survival was 72%, 88%, 87%, and 87% in cohorts 1986 to 1996, 1997 to 2002, 2003 to 2009, and 2010 to 2015, respectively (P < 0.0001). In France, 87% of patients with BA survive nowadays and 22% reach the age of 30 years without transplantation. Improvement of BA prognosis is mainly due to reduced mortality before LT and better outcomes after LT.Lire moins >
Lire la suite >This study analyses the prognosis of biliary atresia (BA) in France since 1986, when both Kasai operation (KOp) and liver transplantation (LT) became widely available. The charts of all patients diagnosed with BA born between 1986 and 2015 and living in France were reviewed. A total of 1428 patients were included; 1340 (94%) underwent KOp. Total clearance of jaundice (total bilirubin ≤20 μmol/L) was documented in 516 patients (39%). Age at KOp (median 59 days, range 6-199) was stable over time. Survival with native liver after KOp was 41%, 35%, 26%, and 22% at 5, 10, 20, and 30 years, stable in the 4 cohorts. 25-year survival with native liver was 38%, 27%, 22%, and 19% in patients operated in the first, second, third month of life or later, respectively (P = 0.0001). Center caseloads had a significant impact on results in the 1986 to 1996 cohort only. 16%, 7%, 7%, and 8% of patients died without LT in the 4 cohorts (P = 0.0001). A total of 753 patients (55%) underwent LT. Patient survival after LT was 79% at 28 years. Five-year patient survival after LT was 76%, 91%, 88%, and 92% in cohorts 1 to 4, respectively (P < 0.0001). Actual BA patient survival (from diagnosis) was 81%. Five-year BA patient survival was 72%, 88%, 87%, and 87% in cohorts 1986 to 1996, 1997 to 2002, 2003 to 2009, and 2010 to 2015, respectively (P < 0.0001). In France, 87% of patients with BA survive nowadays and 22% reach the age of 30 years without transplantation. Improvement of BA prognosis is mainly due to reduced mortality before LT and better outcomes after LT.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Date de dépôt :
2024-01-30T10:28:14Z
2024-02-06T10:09:34Z
2024-02-06T10:09:34Z