{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:29:33Z","timestamp":1790162973624,"version":"4.1.0"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T00:00:00Z","timestamp":1672704000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/ http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims:<\/jats:title>\n            <jats:p>Outcomes after Kasai portoenterostomy (KPE) for biliary atresia remain highly variable for unclear reasons. As reliable early biomarkers predicting KPE outcomes are lacking, we studied the prognostic value of FGF19.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results:<\/jats:title>\n            <jats:p>Serum and liver specimens, obtained from biliary atresia patients (N=87) at KPE or age-matched cholestatic controls (N=26) were included. Serum concentration of FGF19 and bile acids, liver mRNA expression of <jats:italic toggle=\"yes\">FGF19<\/jats:italic>, and key regulators of bile acid synthesis were related to KPE outcomes and liver histopathology. Immunohistochemistry and in situ hybridization were used for the localization of liver FGF19 expression. Serum levels (223 vs. 61\u00a0pg\/mL, <jats:italic toggle=\"yes\">p<\/jats:italic>&lt;0.001) and liver mRNA expression of FGF19 were significantly increased in biliary atresia. Patients with unsuccessful KPE (419 vs. 145\u00a0pg\/mL, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.047), and those subsequently underwent liver transplantation (410 vs. 99\u00a0pg\/mL, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.007) had significantly increased serum, but not liver, FGF19, which localized mainly in hepatocytes. In Cox hazard modeling serum FGF19 &lt;109\u00a0pg\/mL predicted native liver survival (HR: 4.31, <jats:italic toggle=\"yes\">p<\/jats:italic>&lt;0.001) also among patients operated &lt;60 days of age (HR: 8.77, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.004) or after successful KPE (HR: 6.76, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.01). Serum FGF19 correlated positively with increased serum primary bile acids (<jats:italic toggle=\"yes\">R<\/jats:italic>=0.41, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.004) and ductular reaction (<jats:italic toggle=\"yes\">R<\/jats:italic>=0.39, <jats:italic toggle=\"yes\">p<\/jats:italic>=0.004).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Increased serum FGF19 at KPE predicted inferior long-term native liver survival in biliary atresia and was associated with unsuccessful KPE, elevated serum primary bile acids, and ductular reaction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/hep.0000000000000048","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T11:46:29Z","timestamp":1674560789000},"page":"1263-1273","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":37,"title":["Serum FGF19 predicts outcomes of Kasai portoenterostomy in biliary atresia"],"prefix":"10.1097","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4999-4280","authenticated-orcid":false,"given":"Iiris","family":"Nyholm","sequence":"first","affiliation":[{"name":"Pediatric Research Center, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-8391","authenticated-orcid":false,"given":"Maria","family":"Hukkinen","sequence":"additional","affiliation":[{"name":"Pediatric Research Center, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Section of Pediatric Surgery, Pediatric Liver and Gut Research Group, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9869-5706","authenticated-orcid":false,"given":"Marjut","family":"Pihlajoki","sequence":"additional","affiliation":[{"name":"Pediatric Research Center, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3303-6320","authenticated-orcid":false,"given":"Joseph R.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, GOS-UCL Institute of Child Health, London, UK"},{"name":"Department of Pediatric Surgery, King\u2019s College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Tyraskis","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, King\u2019s College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jouko","family":"Lohi","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4ivi","family":"Heikkil\u00e4","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2758-8444","authenticated-orcid":false,"given":"Satu","family":"H\u00e4nninen","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noora","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0396-5137","authenticated-orcid":false,"given":"Katja","family":"Eloranta","sequence":"additional","affiliation":[{"name":"Pediatric Research Center, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7847-5706","authenticated-orcid":false,"given":"Olli","family":"Carp\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9452-0661","authenticated-orcid":false,"given":"Markku","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Pediatric Research Center, Children\u2019s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Department of Pediatrics, Washington University School of Medicine, St. Louis Children\u2019s Hospital, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-2717","authenticated-orcid":false,"given":"Mark","family":"Davenport","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, King\u2019s College Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-6334","authenticated-orcid":false,"given":"Mikko 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