ArticleLiver international : official journal of the International Association for the Study of the Liver2026
Ductular Reaction Underlies Development of Portal Hypertension in Biliary Atresia.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Ductular Reaction Underlies Development of Portal Hypertension in Biliary Atresia.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
BACKGROUND &
aimsAs better understanding of pathophysiology and reliable predictors for portal hypertension (PH) are needed, we investigated how histological ductular reaction (DR) and liver fibrosis predict PH in biliary atresia (BA).
methods60 BA patients treated between 1987 and 2024 at Helsinki University Hospital were enrolled. Patients underwent liver biopsies at Kasai portoenterostomy and 1 year postoperatively. PH was defined as endoscopic detection of oesophageal varices or thrombocytopenia (< 150*109) and splenomegaly. A neural network model was used to quantify proportional DR (DR%) relative to entire liver tissue, composed of cytokeratin-7-positive portal biliary epithelium (BE%) and parenchymal intermediate hepatocytes (PIH%). Fibrosis was measured by Metavir staging and computerized quantification of Sirius-Red-positive area (SRP%). Predictors of PH were studied with AUROC and survival analyses, and Cox regression models.
resultsAfter portoenterostomy, PH was detected in 70% (n = 42) of patients at median age 1.4 years (IQR 0.7-2.6). At portoenterostomy, DR% ≥ 6.9% (p = 0.016) and PIH% ≥ 1.6% (p < 0.001), but not liver fibrosis apart from cirrhosis (n = 5) predicted PH (p = 0.032). At 1 year, DR% ≥ 3.5% (p < 0.001), PIH% ≥ 0.7% (p < 0.001), BE% ≥ 3.2% (p = 0.006) as well as Metavir 3-4 vs. 1-2 (p = 0.037) and SRP% ≥ 28.4% (p = 0.006) predicted PH. Patients with PH showed progression of PIH% (p < 0.001) from portoenterostomy to follow-up biopsy, accompanied by more rapid progression of fibrosis. In univariable regression models, different DR components, but not fibrosis, were associated with PH both at portoenterostomy and follow-up also after successful portoenterostomy.
conclusionDR predicted development of PH at and one year after portoenterostomy, associating with PH more consistently than fibrosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.