{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:27:09Z","timestamp":1788805629665,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study evaluated portal hypertension (PHT) and its predictors among native liver survivors (NLS) of biliary atresia (BA) after Kasai portoenterostomy (KPE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter study using prospectively collected data. The subjects were patients who remained transplant-free for 5\u00a0years after KPE. Their status of PHT was evaluated and variables that predicted PHT were determined by regression analysis and receiver operating characteristic (ROC) curve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six centers from East Asia participated in this study and 320 subjects with KPE between 1980 to 2018 were analyzed. The mean follow-up period was 10.6\u2009\u00b1\u20096.2\u00a0years. At the 5th year after KPE, PHT was found in 37.8% of the subjects (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009121). Patients with KPE done before day 41 of life had the lowest percentage of PHT compared to operation at older age. At 12\u00a0months after KPE, PHT\u2009+\u2009ve subjects had a higher bilirubin level (27.1\u2009\u00b1\u200911.7 vs 12.3\u2009\u00b1\u20097.9\u00a0\u00b5mol\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.000) and persistent jaundice conferred a higher risk for PHT (OR\u2009=\u200912.9 [9.2\u201315.4],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.000). ROC analysis demonstrated that a bilirubin level above 38\u00a0\u00b5mol\/L at 12\u00a0months after KPE predicted PHT development (sensitivity: 78%, specificity: 60%, AUROC: 0.75).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In BA, early KPE protects against the development of PHT among NLSs. Patients with persistent cholestasis at one year after KPE are at a higher risk of this complication. They should receive a more vigilant follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Level III<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-024-05775-0","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T06:01:58Z","timestamp":1721196118000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cholestasis after Kasai operation predicts portal hypertension in native liver survivors of biliary atresia: a multicenter study"],"prefix":"10.1007","volume":"40","author":[{"given":"Patrick Ho Yu","family":"Chung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Harumatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Tsuboi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin Kin Wai","family":"Chan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Wai Yip","family":"Leung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Muto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Kawano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hizuru","family":"Amano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiyoe","family":"Shirota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Koga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Miyano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuyuki","family":"Yamataka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ieiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Kak Yuen","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"issue":"2","key":"5775_CR1","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1002\/hep.20547","volume":"41","author":"P Lykavieris","year":"2005","unstructured":"Lykavieris P, Chardot C, Sokhn M, Gauthier F, Valayer J, Bernard O (2005) Outcome in adulthood of biliary atresia: a study of 63 patients who survived for over 20 years with their native liver. Hepatology 41(2):366\u2013371","journal-title":"Hepatology"},{"issue":"1","key":"5775_CR2","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jhep.2019.03.005","volume":"71","author":"V Jain","year":"2019","unstructured":"Jain V, Burford C, Alexander EC, Sutton H, Dhawan A, Joshi D et al (2019) Prognostic markers at adolescence in patients requiring liver transplantation for biliary atresia in adulthood. J Hepatol 71(1):71\u201377","journal-title":"J Hepatol"},{"issue":"4","key":"5775_CR3","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1097\/MPG.0b013e31812e56ff","volume":"45","author":"V de Ledinghen","year":"2007","unstructured":"de Ledinghen V, Le Bail B, Rebouissoux L, Fournier C, Foucher J, Miette V et al (2007) Liver stiffness measurement in children using fibroscan: feasibility study and comparison with fibrotest, aspartate transaminase to platelets ratio index, and liver biopsy. J Pediatr Gastroenterol Nutr 45(4):443\u2013450","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"5775_CR4","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/MPG.0b013e31826eb0cf","volume":"55","author":"BL Shneider","year":"2012","unstructured":"Shneider BL, Abel B, Haber B, Karpen SJ, Magee JC, Romero R et al (2012) Portal hypertension in children and young adults with biliary atresia. J Pediatr Gastroenterol Nutr 55(5):567\u2013573","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"10099","key":"5775_CR5","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1016\/S0140-6736(17)32284-5","volume":"390","author":"PKH Tam","year":"2017","unstructured":"Tam PKH, Chung PHY, St Peter SD, Gayer CP, Ford HR, Tam GCH et al (2017) Advances in paediatric gastroenterology. Lancet 390(10099):1072\u20131082","journal-title":"Lancet"},{"key":"5775_CR6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/1756-8722-7-27","volume":"7","author":"DJ Araten","year":"2014","unstructured":"Araten DJ, Iori AP, Brown K, Torelli GF, Barberi W, Natalino F et al (2014) Selective splenic artery embolization for the treatment of thrombocytopenia and hypersplenism in paroxysmal nocturnal hemoglobinuria. J Hematol Oncol 7:27","journal-title":"J Hematol Oncol"},{"issue":"3","key":"5775_CR7","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.asjsur.2021.07.056","volume":"45","author":"S Watanabe","year":"2022","unstructured":"Watanabe S, Suzuki T, Tsuchiya T, Kondo Y (2022) Long-term results of splenomegaly after surgery for biliary atresia in the native liver. Asian J Surg 45(3):849\u2013853","journal-title":"Asian J Surg"},{"issue":"3","key":"5775_CR8","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1053\/j.sempedsurg.2012.05.004","volume":"21","author":"L D'Antiga","year":"2012","unstructured":"D\u2019Antiga L (2012) Medical management of esophageal varices and portal hypertension in children. Semin Pediatr Surg 21(3):211\u2013218","journal-title":"Semin Pediatr Surg"},{"issue":"2","key":"5775_CR9","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1097\/MPG.0000000000000400","volume":"59","author":"I Goldschmidt","year":"2014","unstructured":"Goldschmidt I, Brauch C, Poynard T, Baumann U (2014) Spleen stiffness measurement by transient elastography to diagnose portal hypertension in children. J Pediatr Gastroenterol Nutr 59(2):197\u2013203","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"4","key":"5775_CR10","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/MPG.0000000000002069","volume":"67","author":"H Sutton","year":"2018","unstructured":"Sutton H, Fitzpatrick E, Davenport M, Burford C, Alexander E, Dhawan A et al (2018) Transient elastography measurements of spleen stiffness as a predictor of clinically significant varices in children. J Pediatr Gastroenterol Nutr 67(4):446\u2013451","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"6","key":"5775_CR11","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.1053\/j.gastro.2011.08.049","volume":"141","author":"JC Gana","year":"2011","unstructured":"Gana JC, Turner D, Mieli-Vergani G, Davenport M, Miloh T, Avitzur Y et al (2011) A clinical prediction rule and platelet count predict esophageal varices in children. Gastroenterology 141(6):2009\u20132016","journal-title":"Gastroenterology"},{"issue":"7","key":"5775_CR12","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1007\/s00595-014-1024-z","volume":"45","author":"M Nio","year":"2015","unstructured":"Nio M, Wada M, Sasaki H, Tanaka H (2015) Effects of age at Kasai portoenterostomy on the surgical outcome: a review of the literature. Surg Today 45(7):813\u2013818","journal-title":"Surg Today"},{"issue":"1","key":"5775_CR13","doi-asserted-by":"publisher","first-page":"11207","DOI":"10.1038\/s41598-021-90860-w","volume":"11","author":"PHY Chung","year":"2021","unstructured":"Chung PHY, Chan EKW, Yeung F, Chan ACY, Mou JWC, Lee KH et al (2021) Life long follow up and management strategies of patients living with native livers after Kasai portoenterostomy. Sci Rep 11(1):11207","journal-title":"Sci Rep"},{"issue":"3","key":"5775_CR14","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s00383-015-3662-7","volume":"31","author":"M Lishuang","year":"2015","unstructured":"Lishuang M, Zhen C, Guoliang Q, Zhen Z, Chen W, Long L et al (2015) Laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia: a systematic review and meta-analysis of comparative studies. Pediatr Surg Int 31(3):261\u2013269","journal-title":"Pediatr Surg Int"},{"issue":"2","key":"5775_CR15","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1016\/j.jpedsurg.2016.11.022","volume":"52","author":"MH Hussain","year":"2017","unstructured":"Hussain MH, Alizai N, Patel B (2017) Outcomes of laparoscopic Kasai portoenterostomy for biliary atresia: a systematic review. J Pediatr Surg 52(2):264\u2013267","journal-title":"J Pediatr Surg"},{"issue":"11","key":"5775_CR16","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1007\/s00383-021-04964-5","volume":"37","author":"DE Hinojosa-Gonzalez","year":"2021","unstructured":"Hinojosa-Gonzalez DE, Bueno LC, Roblesgil-Medrano A, Salgado-Garza G, Hurtado-Arellano S, Farias JS et al (2021) Laparoscopic vs open portoenterostomy in biliary atresia: a systematic review and meta-analysis. Pediatr Surg Int 37(11):1477\u20131487","journal-title":"Pediatr Surg Int"},{"issue":"9","key":"5775_CR17","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1016\/j.jpedsurg.2015.05.016","volume":"50","author":"Y Chen","year":"2015","unstructured":"Chen Y, Nah SA, Chiang L, Krishnaswamy G, Low Y (2015) Postoperative steroid therapy for biliary atresia: systematic review and meta-analysis. J Pediatr Surg 50(9):1590\u20131594","journal-title":"J Pediatr Surg"},{"issue":"6","key":"5775_CR18","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1111\/liv.14871","volume":"41","author":"AF Carrion","year":"2021","unstructured":"Carrion AF, Lindor KD, Levy C (2021) Safety of fibrates in cholestatic liver diseases. Liver Int 41(6):1335\u20131343","journal-title":"Liver Int"},{"issue":"9","key":"5775_CR19","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1016\/j.cgh.2012.05.008","volume":"10","author":"FD Mendes","year":"2012","unstructured":"Mendes FD, Suzuki A, Sanderson SO, Lindor KD, Angulo P (2012) Prevalence and indicators of portal hypertension in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 10(9):1028\u201333.e2","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-024-05775-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-024-05775-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-024-05775-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T12:14:01Z","timestamp":1734005641000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00383-024-05775-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,17]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["5775"],"URL":"https:\/\/doi.org\/10.1007\/s00383-024-05775-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4689703\/v1","asserted-by":"object"}]},"ISSN":["1437-9813"],"issn-type":[{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,17]]},"assertion":[{"value":"6 July 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}],"article-number":"196"}}