Prognostic factors indicating survival with native liver after Kasai procedure for biliary atresia

Background The number of the bile ducts in the portal canal/measured surface area of the portal canal (BDP ratio) indicates prognosis in biliary atresia (BA), as does an elevated cytokeratin 7 positivity percentage (PCK7). We compared these two markers. Methods We reviewed 32 BA cases undergoing Kasai operation from 1976 to 2016 with >5 portal canals in biopsy samples. Group I required liver transplantation or died within a year of operation ( n = 8). Group II survived with their native liver ( n = 24). We determined the BDP ratio (10 2 /mm 2 ) and PCK7 (%), subdividing patients into three groups by their age at operation: Group A ≤60 days ( n = 6, 1 Group I), 60< Group B ≤90days ( n = 16, 5 Group I), Group C >90 days ( n = 10, 2 Group I). Results PCK7 (%) was 2.71 ± 1.87 in Group I and 4.25 ± 2.56 in Group II ( p = 0.13). BDP ratio (10 2 /mm 2 ) was 1.19 ± 0.424 in Group I and 1.64 ± 0.534 in Group II ( p = 0.04). Both markers were higher in Group C than in Group A or B ( p < 0.01). Conclusion The BDP ratio is a better prognostic indicator than PCK7 in BA.