Does the aminotransferase aspartate to platelet ratio index (APRI) value at the time of kasai portoenterostomy show any relationship to long-term outcome in patients with Biliary Atresia

Abstract

Biliary atresia (BA) is characterised by a progressive obliterative cholangiopathy. If surgical treatment by a Kasai Portoenterostomy (KP) is undertaken early on in life there is the potential for successful bile drainage. The natural disease progression without intervention results in fibrosis and cirrhosis, necessitating liver transplantation before two years of life. Despite the advances in the management of biliary atresia over the recent decades we still do not have a good indicator of which patients will do well after surgery and which will require further intervention for their liver dysfunction. There are many clinical and serological indicators that suggest liver failure, but liver histology remains the gold standard indicating the extent of liver damage. This is, however, being slowly replaced by various new less-invasive biological markers, including the Aminotransferase Aspartate to Platelet Ratio Index (APRi). This study looks at this biological marker for patients with biliary atresia with reference to their level of disease at the time of surgery and whether it is a prognostic tool for long-term outcomes in this group of patients.