{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:50:14Z","timestamp":1775451014698,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,4]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n To investigate the prognostic significance of aspartate aminotransferase to platelet ratio index (APRI) in relation to histopathological features across the clinical course of biliary atresia (BA).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this observational cohort study, we enrolled 135 BA patients with available APRI values at Kasai portoenterostomy (KPE,\n n<\/jats:italic>\n \u2009=\u2009116) or at post\u2010KPE follow\u2010up (\n n<\/jats:italic>\n \u2009=\u200970; serum samples,\n n<\/jats:italic>\n \u2009=\u2009139; liver biopsies,\n n<\/jats:italic>\n \u2009=\u2009139). APRI was matched to manual scorings of liver histology, ductular reaction (DR) analysed using neural network model and fibrosis quantified from Sirius Red\u2010stained sections.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n APRI was elevated at both KPE and post\u2010KPE follow\u2010up (0.92 vs. 1.2,\n p<\/jats:italic>\n \u2009=\u20090.5), and associated with biochemical markers of cholestasis, and decreased liver function. At KPE, APRI was higher in patients failing to resolve cholestasis postoperatively (0.80 vs. 0.96,\n p<\/jats:italic>\n \u2009=\u20090.02) and both at KPE (0.77 vs. 0.94,\n p<\/jats:italic>\n \u2009=\u20090.06) and post\u2010KPE (0.7 vs. 2.1,\n p<\/jats:italic>\n \u2009<\u20090.001) in those with subsequent need for liver transplant (LT). Across the disease course, APRI moderately predicted LT need (at KPE, HR\u2009=\u20091.4,\n p<\/jats:italic>\n \u2009=\u20090.01; post\u2010KPE, HR\u2009=\u20091.2,\n p<\/jats:italic>\n \u2009<\u20090.001). APRI correlated with DR (at KPE,\n R<\/jats:italic>\n \u2009=\u20090.37,\n p<\/jats:italic>\n \u2009<\u20090.001; post\u2010KPE,\n R<\/jats:italic>\n \u2009=\u20090.35,\n p<\/jats:italic>\n \u2009<\u20090.001), composed of biliary epithelium (\n R<\/jats:italic>\n \u2009=\u20090.34,\n p<\/jats:italic>\n \u2009<\u20090.001;\n R<\/jats:italic>\n \u2009=\u20090.25,\n p<\/jats:italic>\n \u2009<\u20090.01) and parenchymal intermediate hepatocytes (\n R<\/jats:italic>\n \u2009=\u20090.33,\n p<\/jats:italic>\n \u2009<\u20090.001;\n R<\/jats:italic>\n \u2009=\u20090.43,\n p<\/jats:italic>\n \u2009<\u20090.001) during the entire clinical course. APRI showed no correlation with quantified liver fibrosis at KPE (\n R<\/jats:italic>\n \u2009=\u20090.16,\n p<\/jats:italic>\n \u2009=\u20090.13), but correlated with quantified fibrosis (\n R<\/jats:italic>\n \u2009=\u20090.22,\n p<\/jats:italic>\n \u2009=\u20090.02) and Metavir staging (\n R<\/jats:italic>\n \u2009=\u20090.46,\n p<\/jats:italic>\n \u2009<\u20090.001) after KPE. No association was observed with portal inflammatory cell infiltration or histological cholestasis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n APRI reflects biliary and portal injury rather than generalised liver fibrosis and associates with poor prognosis in BA.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jpn3.70354","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:44:18Z","timestamp":1769510658000},"page":"929-938","source":"Crossref","is-referenced-by-count":0,"title":["Serum aspartate aminotransferase to platelet ratio index in relation to liver histopathology of biliary atresia"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9598-1260","authenticated-orcid":false,"given":"Nicholas","family":"Nordenheim","sequence":"first","affiliation":[{"name":"Section of Paediatric Surgery, Paediatric Liver and Gut Research Group, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-4280","authenticated-orcid":false,"given":"Iiris","family":"Nyholm","sequence":"additional","affiliation":[{"name":"Section of Paediatric Surgery, Paediatric Liver and Gut Research Group, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"},{"name":"Pediatric Research Centre, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-8391","authenticated-orcid":false,"given":"Maria","family":"Hukkinen","sequence":"additional","affiliation":[{"name":"Section of Paediatric Surgery, Paediatric Liver and Gut Research Group, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"},{"name":"Pediatric Research Centre, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3360-6645","authenticated-orcid":false,"given":"Nelli","family":"Sj\u00f6blom","sequence":"additional","affiliation":[{"name":"Department of Pathology, Diagnostic Centre Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2885-3211","authenticated-orcid":false,"given":"Aino","family":"Mutka","sequence":"additional","affiliation":[{"name":"Department of Pathology, Diagnostic Centre Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jouko","family":"Lohi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Diagnostic Centre Helsinki University Hospital and University of Helsinki Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-2717","authenticated-orcid":false,"given":"Mark","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery King's College Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-6334","authenticated-orcid":false,"given":"Mikko P.","family":"Pakarinen","sequence":"additional","affiliation":[{"name":"Section of Paediatric Surgery, Paediatric Liver and Gut Research Group, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"},{"name":"Pediatric Research Centre, Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland"},{"name":"Department of Women's and Children's Health Karolinska Institute Stockholm 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