Effects of the infant stool color card screening program on 5-year outcome of biliary Atresia in Taiwan

Tien Hau Lien, Mei Hwei Chang, Jia Feng Wu, Huey Ling Chen, Hung Chang Lee, An Chyi Chen, Mao Meng Tiao, Tzee Chung Wu, Yao Jong Yang, Chieh Chung Lin, Ming Wei Lai, Hong Yuan Hsu, Yen Hsuan Ni

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146 Citations (Scopus)

Abstract

In Taiwan, a screening system using an infant stool color card to promote the early diagnosis of biliary atresia (BA) was established in 2002. This study aimed to investigate the 5-year outcome of BA before and after using the screening program. BA patients were divided into three cohorts according to their birth dates. The patients in cohort A (n = 89) were born before the stool card screening program (1990-2000); those in cohort B (n = 28) were screened by the stool card regional screening program (2002-2003); and those in cohort C (n = 74) were screened by the stool card universal screening program (2004-2005). The relative odds ratios were computed using logistic regression to compare the different factors affecting survival time. The rate of age at Kasai operation <60 days was 49.4% and 65.7% in cohorts A and B+C, respectively (P = 0.02). The jaundice-free (total serum bilirubin <2.0 mg/dL) rate 3 months after surgery was 34.8% and 60.8% in cohorts A and B+C, respectively (P < 0.001). The 3-year jaundice-free survival rate with native liver was 31.5% in cohort A and 56.9% in cohort B+C (P < 0.001), whereas the 3-year overall survival rates were 64.0% and 89.2%, respectively (P < 0.001). The 5-year jaundice-free survival rate with native liver was 27.3% in cohort A and 64.3% in cohort B (P < 0.001), and the 5-year overall survival rates were 55.7% and 89.3%, respectively (P < 0.001). Conclusion: The stool color card screening program for BA allows for earlier Kasai operation, which increases the jaundice-free rate at 3 months postsurgery. With higher surgical success rates, the 3- and 5-year outcome of BA patients in Taiwan improves remarkably.

Original languageEnglish
Pages (from-to)202-208
Number of pages7
JournalHepatology
Volume53
Issue number1
DOIs
Publication statusPublished - 2011 Jan

All Science Journal Classification (ASJC) codes

  • Hepatology

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