Abstract
Purpose: The aim of this study was to study the late clinical features of biliary atresia in relation to pregnancy. Materials and Methods: Of the 175 patients with biliary atresia operated on at our department, the data for 49 patients (18 males, 31 females) older than 15 years were reviewed and analyzed. Results: Six patients delivered 7 newborns (5 with their native liver and 1 with a transplanted liver). Although one of the patients delivered twice after transplantation, another underwent transplantation after delivery. None of the 7 newborns showed any congenital anomalies; however, 6 were small-for-date newborns. Their birth weight tended to be inversely related to the mothers' age at delivery. An additional 13 patients required liver transplantation, of whom 1 died after transplantation and 1 died before transplantation. The remaining 30 patients showed uneventful courses without transplantation. The age at Kasai operation was significantly higher in the 5 patients who delivered babies with their native liver compared with that in these 30 patients (88.0 vs 68.6 days). A significant difference between these 5 patients and those who died or required transplantation before pregnancy was recognized even at the age of puberty in the alanine aminotransferase (36.5 ± 26.5 vs 126.4 ± 56.1 IU/L), aspartate aminotransferase (36.2 ± 26.5 vs 114.2 ± 48.9 IU/L), and choline esterase (249.7 ± 64.8 vs 163.5 ± 40.2 IU/L). Conclusions: The age at Kasai operation may not necessarily impact the late clinical course; however, liver function at puberty may predict the subsequent clinical course, including the safety of pregnancy. The management strategies should be revised after puberty.
| Original language | English |
|---|---|
| Pages (from-to) | 1852-1855 |
| Number of pages | 4 |
| Journal | Journal of Pediatric Surgery |
| Volume | 40 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2005 Dec |
| Externally published | Yes |
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Keywords
- Biliary atresia
- Delivery
- Kasai operation
- Pregnancy
- Puberty
ASJC Scopus subject areas
- Surgery
Cite this
Biliary atresia and pregnancy : Puberty may be an important point for predicting the outcome. / Kuroda, Tatsuo; Saeki, Morihiro; Morikawa, Nobuyuki; Fuchimoto, Yasushi.
In: Journal of Pediatric Surgery, Vol. 40, No. 12, 12.2005, p. 1852-1855.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Biliary atresia and pregnancy
T2 - Puberty may be an important point for predicting the outcome
AU - Kuroda, Tatsuo
AU - Saeki, Morihiro
AU - Morikawa, Nobuyuki
AU - Fuchimoto, Yasushi
PY - 2005/12
Y1 - 2005/12
N2 - Purpose: The aim of this study was to study the late clinical features of biliary atresia in relation to pregnancy. Materials and Methods: Of the 175 patients with biliary atresia operated on at our department, the data for 49 patients (18 males, 31 females) older than 15 years were reviewed and analyzed. Results: Six patients delivered 7 newborns (5 with their native liver and 1 with a transplanted liver). Although one of the patients delivered twice after transplantation, another underwent transplantation after delivery. None of the 7 newborns showed any congenital anomalies; however, 6 were small-for-date newborns. Their birth weight tended to be inversely related to the mothers' age at delivery. An additional 13 patients required liver transplantation, of whom 1 died after transplantation and 1 died before transplantation. The remaining 30 patients showed uneventful courses without transplantation. The age at Kasai operation was significantly higher in the 5 patients who delivered babies with their native liver compared with that in these 30 patients (88.0 vs 68.6 days). A significant difference between these 5 patients and those who died or required transplantation before pregnancy was recognized even at the age of puberty in the alanine aminotransferase (36.5 ± 26.5 vs 126.4 ± 56.1 IU/L), aspartate aminotransferase (36.2 ± 26.5 vs 114.2 ± 48.9 IU/L), and choline esterase (249.7 ± 64.8 vs 163.5 ± 40.2 IU/L). Conclusions: The age at Kasai operation may not necessarily impact the late clinical course; however, liver function at puberty may predict the subsequent clinical course, including the safety of pregnancy. The management strategies should be revised after puberty.
AB - Purpose: The aim of this study was to study the late clinical features of biliary atresia in relation to pregnancy. Materials and Methods: Of the 175 patients with biliary atresia operated on at our department, the data for 49 patients (18 males, 31 females) older than 15 years were reviewed and analyzed. Results: Six patients delivered 7 newborns (5 with their native liver and 1 with a transplanted liver). Although one of the patients delivered twice after transplantation, another underwent transplantation after delivery. None of the 7 newborns showed any congenital anomalies; however, 6 were small-for-date newborns. Their birth weight tended to be inversely related to the mothers' age at delivery. An additional 13 patients required liver transplantation, of whom 1 died after transplantation and 1 died before transplantation. The remaining 30 patients showed uneventful courses without transplantation. The age at Kasai operation was significantly higher in the 5 patients who delivered babies with their native liver compared with that in these 30 patients (88.0 vs 68.6 days). A significant difference between these 5 patients and those who died or required transplantation before pregnancy was recognized even at the age of puberty in the alanine aminotransferase (36.5 ± 26.5 vs 126.4 ± 56.1 IU/L), aspartate aminotransferase (36.2 ± 26.5 vs 114.2 ± 48.9 IU/L), and choline esterase (249.7 ± 64.8 vs 163.5 ± 40.2 IU/L). Conclusions: The age at Kasai operation may not necessarily impact the late clinical course; however, liver function at puberty may predict the subsequent clinical course, including the safety of pregnancy. The management strategies should be revised after puberty.
KW - Biliary atresia
KW - Delivery
KW - Kasai operation
KW - Pregnancy
KW - Puberty
UR - http://www.scopus.com/inward/record.url?scp=28844509714&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=28844509714&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2005.08.026
DO - 10.1016/j.jpedsurg.2005.08.026
M3 - Article
C2 - 16338304
AN - SCOPUS:28844509714
VL - 40
SP - 1852
EP - 1855
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 12
ER -