PMID- 28974877
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 0971-9261 (Print)
IS  - 1998-3891 (Electronic)
IS  - 0971-9261 (Linking)
VI  - 22
IP  - 4
DP  - 2017 Oct-Dec
TI  - Pre-operative Hepatic Artery Resistive Index is a Non-invasive Predictive 
      Indicator of Prognosis in Biliary Atresia.
PG  - 237-241
LID - 10.4103/jiaps.JIAPS_103_17 [doi]
AB  - AIMS: The aim of this study is to evaluate hepatic artery resistive index (HARI) 
      as a noninvasive prognostic predictor by correlating it with peripheral blood 
      nitric oxide (NO) levels, portal pressure (PP) and histopathological changes in 
      the liver in patients of biliary atresia (BA). MATERIALS AND METHODS: Twenty-five 
      patients were included in the study prospectively from November 2012 to June 
      2014. All patients underwent Doppler sonography to calculate the HARI 
      preoperatively. Peripheral blood NO was also measured preoperatively. Biochemical 
      liver function tests (LFTs) were measured preoperatively and at 1, 3, and 6 
      months postoperatively. The PP was measured intraoperatively, and a liver biopsy 
      was taken in all patients. Disappearance of jaundice defined successful surgical 
      treatment. Postoperatively, a hepatobiliary IminoDiacetic Acid scan (HIDA) was 
      done to demonstrate a patent bilio-enteric pathway. RESULTS: The mean 
      preoperative HARI was 0.78 +/- 0.105, and the median was 0.80 (range 0.60-1.0). The 
      median HARI was used to correlate the other parameters; 13 (52%) patients had 
      HARI >/=0.8. The mean PP was 24.96 +/- 6.54 mmHg. The HARI had a strong correlation 
      with PP (P = 0.0001) and (NO) (P = 0.0001); with every 0.1 increase in HARI, 
      there was 5.2 mmHg increase in PP and 3.8 mumol/L increase in NO. The histological 
      parameters which reached significance in relation to HARI were hepatocellular 
      damage, bile duct inflammation, portal inflammation, and portal fibrosis. The 
      postoperative improvement in LFT was significantly better in patients with HARI 
      <0.8. All four patients who died during or after the study period had HARI >0.8, 
      elevated PP, and NO levels. CONCLUSIONS: Preoperative HARI was found to have a 
      direct correlation with PP and peripheral blood NO as a measure of portal 
      hypertension. A preoperative HARI >/=0.8 should be considered as a risk factor for 
      poor outcomes in BA.
FAU - Mittal, Deepak
AU  - Mittal D
AD  - Department of Pediatric Surgery, All India Institute of Medical Sciences, New 
      Delhi, India.
FAU - Bhatnagar, Veereshwar
AU  - Bhatnagar V
AD  - Department of Pediatric Surgery, All India Institute of Medical Sciences, New 
      Delhi, India.
FAU - Agarwala, Sandeep
AU  - Agarwala S
AD  - Department of Pediatric Surgery, All India Institute of Medical Sciences, New 
      Delhi, India.
FAU - Srinivas, Maddur
AU  - Srinivas M
AD  - Department of Pediatric Surgery, All India Institute of Medical Sciences, New 
      Delhi, India.
FAU - Jana, Manisha
AU  - Jana M
AD  - Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Gupta, Arun Kumar
AU  - Gupta AK
AD  - Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Das, Nibhriti
AU  - Das N
AD  - Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Singh, Manoj Kumar
AU  - Singh MK
AD  - Department of Pathology, All India Institute of Medical Sciences, New Delhi, 
      India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - J Indian Assoc Pediatr Surg
JT  - Journal of Indian Association of Pediatric Surgeons
JID - 101179870
PMC - PMC5615899
OTO - NOTNLM
OT  - Biliary atresia
OT  - hepatic artery resistive index
OT  - liver histology
OT  - nitric oxide
OT  - portal hypertension
OT  - portal pressure
COIS- There are no conflicts of interest.
EDAT- 2017/10/05 06:00
MHDA- 2017/10/05 06:01
PMCR- 2017/10/01
CRDT- 2017/10/05 06:00
PHST- 2017/10/05 06:00 [entrez]
PHST- 2017/10/05 06:00 [pubmed]
PHST- 2017/10/05 06:01 [medline]
PHST- 2017/10/01 00:00 [pmc-release]
AID - JIAPS-22-237 [pii]
AID - 10.4103/jiaps.JIAPS_103_17 [doi]
PST - ppublish
SO  - J Indian Assoc Pediatr Surg. 2017 Oct-Dec;22(4):237-241. doi: 
      10.4103/jiaps.JIAPS_103_17.