Predicting factor of quality of life in long-term jaundice-free survivors after the Kasai operation

Uchida, Keiichi; Urata, Hisashi; Suzuki, Hiroshi; Inoue, Mikihiro; Konishi, Naomi; Araki, Toshimitsu; Miki, Chikao; Kusunoki, Masato

doi:10.1016/j.jpedsurg.2004.03.055

« Previous Next »Journal of Pediatric Surgery
Volume 39, Issue 7 , Pages 1040-1044, July 2004

Predicting factor of quality of life in long-term jaundice-free survivors after the Kasai operation

Keiichi Uchida
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Hisashi Urata
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Hiroshi Suzuki
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Mikihiro Inoue
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Naomi Konishi
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Toshimitsu Araki
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Chikao Miki
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Mie Prefectural General Medical Center, Mie, Japan
Masato Kusunoki
- Second Department of Surgery, Mie University School of Medicine, Mie, Japan
- Address reprint requests to Masato Kusunoki, MD, PhD, Second Department of Surgery, Mie University School of Medicine, Edobashi 2-174, Tsu, Mie 514-8507, Japan

Abstract

Background/Purpose

The aim of this study was to determine simple predictors for quality of life (QOL) in long-term jaundice-free survivors after the Kasai operation.

Methods

Kasai’s original portoenterostomy was performed on 55 patients with biliary atresia. Among them, records were reviewed retrospectively of 35 long-term (at least 5 years) and jaundice-free (clearance in bilirubin level less than 1.0 mg/dL after Kasai operation) survivors. The patients were divided into 2 groups based on QOL, and the differences in clinical and laboratory data were analyzed statistically.

Results

The ages at Kasai operation, histologic, fibrosis grade of liver biopsy specimen at operation, the first onset and frequency of postoperative cholangitis, and postoperative clearance speed of jaundice after Kasai operation were not significantly different between the 2 groups. The aspartate aminotransferase (AST) level at 1 year was significantly correlated with the serum concentration of hyaluronic acid and an independent predictor for QOL in long-term jaundice-free survivors of the Kasai operation.

Conclusions

The serum AST level at 1 year was a simple, strong predicting factor of QOL and liver dysfunction in long-term jaundice-free survivors after Kasai operation and may prove useful in planning liver transplantation.

Keywords: Biliary atresia, quality of life, predicting factor