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Use of the aspartate aminotransferase to platelet ratio index to follow liver fibrosis progression in infants with short gut.

Abstract：

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.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Mangus RS,O'Connor MG,Tector AJ,Lim JD,Vianna RM

doi

10.1016/j.jpedsurg.2010.02.098

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

1266-73

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(10)00217-4

journal_volume

45

pub_type

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