{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:17:05Z","timestamp":1788437825462,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"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":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to assess whether steroid\u2010based regimen enhances the clearance of jaundice and improves native liver survival (NLS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included all infants with biliary atresia (BA) undergoing Kasai portoenterostomy (KPE) at our centre. The algorithm\u2010initiated prednisolone was initiated if stools remained acholic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 127 infants, 70 formed the steroid group (SG) and 57 the historical cohort (HC). Jaundice clearance at 6 months was superior with steroids (61.4% vs. 38.6%; odds ratio [OR] 2.53, 95% confidence interval [CI] 1.23\u20135.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). Kaplan\u2013Meier analysis demonstrated improved 24\u2010month NLS (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044) in SG. Multivariate analysis identified younger age at KPE (adjusted odds ratio [aOR] 1.021 per day, 95% CI 1.004\u20131.038,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), lower pre\u2010operative bilirubin (aOR 1.163, 95% CI 1.024\u20131.320,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) and steroid use (aOR 2.13, 95% CI 1.001\u20134.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.050) as independent predictors of success.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Moderate\u2010dose prednisolone after KPE enhances early bile drainage and prolongs native liver survival. Optimal benefit is achieved when surgery is performed at \u226470 days of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov identifier: NCT06447051 (Clinicaltrials.gov)\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06447051\">https:\/\/clinicaltrials.gov\/study\/NCT06447051<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70458","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:54:26Z","timestamp":1779360866000},"page":"223-230","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of post\u2010Kasai steroid\u2010based protocol in biliary atresia"],"prefix":"10.1002","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2380-2157","authenticated-orcid":false,"family":"Anmol","sequence":"first","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-8625","authenticated-orcid":false,"given":"Seema","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikrant","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikrant Bihari","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hepatology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragini","family":"Kilambi","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Rastogi","sequence":"additional","affiliation":[{"name":"Department of Hepatopathology Institute of Liver and Biliary Sciences New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318282a913"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80312-2"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2009.159780"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1665-2681(19)31789-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0742"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.08.035"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/tp.2016.10.08"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.04.013"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21873"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2623"},{"issue":"4","key":"e_1_2_8_12_1","first-page":"222","article-title":"Efficacy of postoperative high\u2010dose steroids in infants with biliary atresia: a meta\u2010analysis","volume":"25","author":"Dong XT","year":"2020","journal-title":"Hong Kong J Paediatr"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.956093"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1329899"},{"issue":"5","key":"e_1_2_8_15_1","article-title":"Glucocorticosteroids for infants with biliary atresia following Kasai portoenterostomy","volume":"5","author":"Tyraskis A","year":"2018","journal-title":"Cochr Database Syst 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