Evidence map›Paper›PMID 40028801›Full record

Observational studyJournal of pediatric gastroenterology and nutrition2025

Serum bile acids early after portoenterostomy are predictive for native liver survival and portal hypertension in biliary atresia.

Linda Anderson, Maria Hukkinen, Iiris Nyholm, Mikko Niemi, Mikko P Pakarinen

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of pediatric gastroenterology and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Ductular Reaction Underlies Development of Portal Hypertension in Biliary Atresia.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  2. Review
  3. Article
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  5. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Linda AndersonSection of Pediatric Surgery, Pediatric Liver and Gut Research Group, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Maria HukkinenSection of Pediatric Surgery, Pediatric Liver and Gut Research Group, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-2622-8391
Iiris NyholmSection of Pediatric Surgery, Pediatric Liver and Gut Research Group, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Mikko NiemiDepartment of Clinical Pharmacology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Mikko P PakarinenSection of Pediatric Surgery, Pediatric Liver and Gut Research Group, New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Funding

Finnish Pediatric Research FoundationSigrid Jusélius Foundation
6 · The paper itself

Abstract

objectivesTo compare the predictive value of serum bile acids on native liver survival (NLS) and portal hypertension (PH) at various time points early after portoenterostomy (PE) in biliary atresia (BA).

methodsThis was a retrospective observational study. Serum bilirubin and bile acid concentrations were defined by enzymatic spectrophotometry 1, 3, and 6 months after PE. After defining optimal bilirubin and bile acids cutoffs by area under the receiver operating characteristic (AUROC) curves, cutoffs were compared with other predictors of NLS and PH in Cox regression.

resultsOut of 56 patients, 42 (75%) achieved clearance of jaundice (COJ, bilirubin <20 µmol/L at 6 months). Both bilirubin and bile acids at 3 and 6 months were accurate predictors of NLS among all patients (AUROC 0.82-0.91, p < 0.001). In COJ patients, bile acids (AUROC 0.82, p = 0.003), but not bilirubin, at 1 month also predicted NLS. Among all patients, the strongest predictors of NLS were bilirubin >18.5 µmol/L and bile acids >150 µmol/L at 3 months, increasing the risk of transplantation/death seven- and eightfold, respectively (p < 0.001 for both). In COJ patients, the strongest predictor of NLS was bile acids >119 µmol/L at 3 months, increasing the risk of transplantation/death 12-fold (p = 0.014). Bile acids and bilirubin at 3 and 6 months predicted PH development in COJ patients with moderate accuracy (AUROC 0.72-0.78, p = 0.004-0.019). Bilirubin >8.5 µmol/L and bile acids >78 µmol/L at 6 months increased PH risk 13-fold (p < 0.001) and 4-fold (p = 0.006).

conclusionsSerum bile acids offer a simple and useful additional tool to predict PE outcomes in BA, particularly after COJ.

Indexed as

Bile Acids and SaltsBiliary AtresiaHypertension, PortalLiverPortoenterostomy, HepaticBilirubinBiomarkersFemaleHumansInfantInfant, NewbornMalePredictive Value of TestsRetrospective StudiesROC CurveBile Acids and SaltsBilirubinBiomarkersclearance of jaundiceesophageal varicesliver transplantation

Identifiers

PMID40028801
PMCPMC11874233

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.