{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:08:45Z","timestamp":1790845725237,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T00:00:00Z","timestamp":1527120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>We investigated the utility of transient elastography (TE) for diagnosing biliary atresia (BA) in cholestatic infants and predicting the outcome of BA. Forty\u2010eight cholestatic infants (9\u201087 days of age) with direct bilirubin level &gt;1 mg\/dL were enrolled. Liver stiffness measurement (LSM) by TE was performed during the cholestasis workup, and 15 subjects were diagnosed as BA. We assessed liver histology using liver biopsies from 36 subjects and graded fibrosis status using the METAVIR score. BA infants had significantly higher LSM values and METAVIR scores than non\u2010BA cholestatic infants. A receiver operating characteristic (ROC) curve analysis showed that an LSM &gt;7.7 kPa was predictive of BA among cholestatic infants (sensitivity = 80%; specificity = 97%; area under the curve [AUC] = 85.3%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.0001). Cholestatic infants with an LSM &gt;7.7 kPa were more likely to be diagnosed with BA (odds ratio [OR] = 128; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Very early measurement of LSM after hepatoportoenterostomy (HPE) is associated with occurrence of thrombocytopenia, splenomegaly, and esophageal varices 6 months post\u2010HPE. Five of the BA subjects were awaiting or had received liver transplantation (LT), and they had a significantly higher LSM measured 1 week post\u2010HPE than that in the other BA subjects (26.0 vs. 10.8 kPa; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.006). A Cox proportional analysis demonstrated that the need for LT was significantly higher in BA subjects with LSM &gt;16 kPa measured 1 week post\u2010HPE than other BA subjects (hazard ratio [HR] = 10.16; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.04). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> LSM assessment during the workup of cholestatic infants may facilitate the diagnosis of BA. LSM post\u2010HPE may predict complications and the need for early LT in infants with BA. (H<jats:sc>epatology<\/jats:sc> 2018).<\/jats:p>","DOI":"10.1002\/hep.29856","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T23:02:37Z","timestamp":1519772557000},"page":"616-624","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":81,"title":["Transient elastography is useful in diagnosing biliary atresia and predicting prognosis after hepatoportoenterostomy"],"prefix":"10.1097","volume":"68","author":[{"given":"Jia\u2010Feng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pediatrics,National Taiwan University Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chee\u2010Seng","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery,National Taiwan University Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Hsi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology,National Taiwan University Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung\u2010Ming","family":"Jeng","sequence":"additional","affiliation":[{"name":"Department of Hepatitis Research Center,National Taiwan University Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huey\u2010Ling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,National Taiwan University Hospital,Taipei,Taiwan"},{"name":"Department of Pediatrics,Taipei Tzu Chi Hospital,New Taipei City,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen\u2010Hsuan","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,National Taiwan University Hospital,Taipei,Taiwan"},{"name":"Department of Pediatrics,Taipei Tzu Chi Hospital,New Taipei City,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong\u2010Yuan","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,National Taiwan University Hospital,Taipei,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u2010Hwei","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics,National Taiwan University Hospital,Taipei,Taiwan"},{"name":"Department of Pediatrics,Taipei Tzu Chi Hospital,New Taipei City,Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,5,24]]},"reference":[{"key":"hep29856-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/hep.20185","article-title":"Biliary Atresia Research Consortium (BARC)","volume":"39","year":"2004","journal-title":"Hepatology"},{"key":"hep29856-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1002\/hep.21790","article-title":"Screening and outcomes in biliary atresia: summary of a National Institutes of Health workshop","volume":"46","year":"2007","journal-title":"Hepatology"},{"key":"hep29856-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1016\/S0140-6736(09)60946-6","article-title":"Biliary atresia","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"hep29856-bib-0004-20241017","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/BF02469507","article-title":"Advances in treatment of biliary atresia","volume":"13","year":"1983","journal-title":"Jpn J Surg"},{"key":"hep29856-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/S1089-3261(05)70141-0","article-title":"Biliary atresia. 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