Document Detail


Use of the aspartate aminotransferase to platelet ratio index to follow liver fibrosis progression in infants with short gut.
MedLine Citation:
PMID:  20620330     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Infants with parenteral nutrition dependence may develop liver dysfunction and progress to liver failure requiring transplantation. The aspartate aminotransferase-to-platelet ratio index (APRI) has good correlation with liver fibrosis progression in adults. This study applies APRI scoring to parenteral nutrition-dependant, short-gut infants to determine hepatic fibrosis progression. METHODS: Laboratory values and biopsies were collected from initial intestinal resection (time 0) up to transplantation (end). Fibrosis scoring ranged from F0 (normal) to F4 (cirrhosis). Children were divided into 3 groups: (1) isolated intestine; and combined liver/intestine with gestational age (2) 34 weeks or greater and (3) 30 weeks or less. Liver function values over time, including calculated APRI, were analyzed as predictors of fibrosis. RESULTS: Fifteen children who had 33 biopsies were included. Median APRI by fibrosis grade was F < or = 2: 1.88, F3: 3.23, and F4: 14.16 (P < .01). Median APRI at transplant by study group was (1) isolated intestine: 2.47, (2) liver/intestine 35 weeks or longer EGA: 14.16, and (3) liver/intestine 30 weeks or less EGA: 14.74 (P = .04). CONCLUSION: Progression of APRI up to 60 days initially demonstrates similar values among study groups, but over time the score distinguishes those children with impending liver cirrhosis and differentiates fibrosis grade and study group.
Authors:
Richard S Mangus; Michael G O'Connor; A Joseph Tector; Joel D Lim; Rodrigo M Vianna
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1266-73     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Affiliation:
Department of Surgery, Transplant Section, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA. rmangus@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Aspartate Aminotransferases / blood*
Biopsy
Blood Platelets / pathology*
Child, Preschool
Disease Progression
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Intestine, Small / pathology,  surgery*
Liver / pathology
Liver Cirrhosis / blood*,  etiology,  surgery
Liver Transplantation
Male
Parenteral Nutrition
Platelet Count
Prognosis
Short Bowel Syndrome / blood,  complications*,  therapy
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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