{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:02:24Z","timestamp":1791403344851,"version":"4.3.3"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>In biliary atresia, serum bilirubin is commonly used to predict outcomes after Kasai portoenterostomy (KP). Infants with persistently high levels invariably need liver transplant, but those achieving normalized levels have a less certain disease course. We hypothesized that serum bile acid levels could help predict outcomes in the latter group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach and Results:<\/jats:title>\n                    <jats:p>\n                      Participants with biliary atresia from the Childhood Liver Disease Research Network were included if they had normalized bilirubin levels 6\u2009months after KP and stored serum samples from the 6\u2010month post\u2010KP clinic visit (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a0137). Bile acids were measured from the stored serum samples and used to divide participants into \u226440\u2009\u03bcmol\/L (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a043) or\u2009&gt;40\u2009\u03bcmol\/L (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u00a0=\u00a094) groups. At 2\u2009years of age, the \u226440\u2009\u03bcmol\/L compared with &gt;40\u2009\u03bcmol\/L group had significantly lower total bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma\u2010glutamyltransferase, bile acids, and spleen size, as well as significantly higher albumin and platelet counts. Furthermore, during 734 person\u2010years of follow\u2010up, those in the \u226440\u2009\u03bcmol\/L group were significantly less likely to develop splenomegaly, ascites, gastrointestinal bleeding, or clinically evident portal hypertension. The \u226440\u2009\u03bcmol\/L group had a 10\u2010year cumulative incidence of liver transplant\/death of 8.5% (95% CI: 1.1%\u201326.1%), compared with 42.9% (95% CI: 28.6%\u201356.4%) for the &gt;40\u2009\u03bcmol\/L group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u00a0=\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Serum bile acid levels may be a useful prognostic biomarker for infants achieving normalized bilirubin levels after KP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hep.32800","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T01:38:05Z","timestamp":1663810685000},"page":"862-873","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":46,"title":["Serum bile acids as a prognostic biomarker in biliary atresia following Kasai portoenterostomy"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-2294","authenticated-orcid":false,"given":"Sanjiv","family":"Harpavat","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Pediatrics, Hepatology and Nutrition, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran","family":"Hawthorne","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth D. R.","family":"Setchell","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica\u00a0Narvaez","family":"Rivas","sequence":"additional","affiliation":[{"name":"Division of Pathology and Laboratory Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5075-8077","authenticated-orcid":false,"given":"Lisa","family":"Henn","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A.","family":"Beil","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3379-7592","authenticated-orcid":false,"given":"Saul J.","family":"Karpen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9998-5692","authenticated-orcid":false,"given":"Vicky\u00a0L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4056-7752","authenticated-orcid":false,"given":"Estella M.","family":"Alonso","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9667-7742","authenticated-orcid":false,"given":"Jorge A.","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen L.","family":"Guthery","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5949-7363","authenticated-orcid":false,"given":"Simon","family":"Horslen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Pediatrics, University of Washington Medical Center and Seattle Children's, Seattle, Washington, USA"},{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1539-6672","authenticated-orcid":false,"given":"Kathy M.","family":"Loomes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"McKiernan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8416-7905","authenticated-orcid":false,"given":"John\u00a0C.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Transplant Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9263-2870","authenticated-orcid":false,"given":"Robert M.","family":"Merion","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8708-0298","authenticated-orcid":false,"given":"Jean P.","family":"Molleston","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children, Indianapolis, Indiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7953-7622","authenticated-orcid":false,"given":"Philip","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies, King's College, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0487-6416","authenticated-orcid":false,"given":"Kasper S.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, Department of Surgery, Children's Hospital of Los Angeles, 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