Utility of liver function tests including aminotransferase-to-platelet ratio index in monitoring liver dysfunction in short-gut infants of varying ages and intestinal lengths

Michael O'Connor, Richard Mangus, A. Joseph Tector, Jonathan A. Fridell, Rodrigo M. Vianna

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background/Purpose: Aspartate aminotransferase-to-platelet ratio index (APRI) has good correlation with liver fibrosis progression in the infant and toddler short-gut population. This study applies laboratory liver function testing, including APRI, to monitor liver dysfunction over time for short-gut infants, with further analysis of at-risk subpopulations. Methods: Study inclusion criteria included infants younger than 1 year at initial intestinal resection with subsequent continuous parenteral nutrition dependence of 3 months minimum. Bilirubin, aspartate aminotransferase, alanine aminotransferase, APRI, and biopsies were collected for 26 weeks postresection. Subgroup analysis was stratified by (1) estimated gestational age, (2) age at intestinal resection (AGE), and (3) remaining intestinal length. Results: Thirty-one children were included, all with AGE younger than 2 months at initial intestinal resection (mean, 13 days). Aminotransferase-to-platelet ratio index was the only marker associated with fibrosis progression (median, APRI by METAVIR grade: F0/F1/F2, 1.9; F3, 5.7; F4, 14.7 [P = .02]). At 8 and 18 weeks postresection, there are separations seen within study subgroups, indicating the onset and progression of liver dysfunction. Conclusion: Aminotransferase-to-platelet ratio index is associated with liver fibrosis progression in this population. There are marked changes in liver dysfunction at 8 and 18 weeks postresection, with subgroup differences within estimated gestational age, AGE, and remaining intestinal length.

Original languageEnglish
Pages (from-to)1057-1062
Number of pages6
JournalJournal of Pediatric Surgery
Volume46
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Liver Function Tests
Transaminases
Liver Diseases
Blood Platelets
Aspartate Aminotransferases
Liver Cirrhosis
Gestational Age
Parenteral Nutrition
Alanine Transaminase
Bilirubin
Population
Fibrosis
Biopsy
Liver

Keywords

  • APRI
  • Liver dysfunction
  • Liver function tests
  • Short gut

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Utility of liver function tests including aminotransferase-to-platelet ratio index in monitoring liver dysfunction in short-gut infants of varying ages and intestinal lengths. / O'Connor, Michael; Mangus, Richard; Tector, A. Joseph; Fridell, Jonathan A.; Vianna, Rodrigo M.

In: Journal of Pediatric Surgery, Vol. 46, No. 6, 06.2011, p. 1057-1062.

Research output: Contribution to journalArticle

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