Using 99m Tc-DTPA galactosyl human serum albumin liver scintigraphy as a prognostic indicator in jaundice-free patients with biliary atresia

Masaki Nio, Motoshi Wada, Hideyuki Sasaki, Hiromu Tanaka, Megumi Nakamura, Hironori Kudo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: We evaluated the clinical significance of follow-up data, including 99m Tc-DTPA galactosyl human serum albumin ( 99m Tc-GSA) liver scintigraphy data, as prognostic indicators for jaundice-free patients with biliary atresia (BA). Methods: Of 87 patients who underwent Kasai portoenterostomy (KP) between 1991 and 2012, 45 jaundice-free patients aged 1–2 years underwent 99m Tc-GSA scintigraphy and were classified into 2 groups: those who survived with a native liver (Group A, n = 34) and those who required liver transplantation (LTx) (Group B, n = 11). We compared 99m Tc-GSA scintigraphy data (HH15, LHL15, and HH15/LHL15 [H/L15]) and liver function test (LFT) results between the groups. The patients underwent a second 99m Tc-GSA scintigraphy at approximately 5 years of age. Results: All patients survived. HH15, H/L15, total bilirubin, direct bilirubin, gamma-glutamyl transpeptidase, and alanine transaminase levels were higher in Group B than in Group A (p < 0.05). Total and direct bilirubin levels were associated with H/L15 (p < 0.05). There were no significant changes in results between the first and second 99m Tc-GSA scintigraphy in Group A. Conclusions: Mid- and long-term prognoses may be predicted using 99m Tc-GSA scintigraphy data and LFTs in patients aged 1–2 years. We recommend regular monitoring of postoperative data following KP, even in jaundice-free patients. Level of evidence: III.

Original languageEnglish
Pages (from-to)2412-2415
Number of pages4
JournalJournal of Pediatric Surgery
Volume53
Issue number12
DOIs
Publication statusPublished - 2018 Dec

Keywords

  • Biliary atresia
  • Functional hepatic reserve
  • Kasai portoenterostomy
  • Prognostic factor
  • Tc-GSA liver scintigraphy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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