Abstract Objectives After hepatoportoenterostomy (HPE), a minority of biliary atresia (BA) patients reach adolescence without liver transplantation. Several serum markers have been suggested to better predict post‐HPE outcomes in BA patients. We aimed to identify serum predictors of native liver survival (NLS) in post‐HPE BA patients. Methods We searched PubMed, MEDLINE, SCOPUS, and EMBASE databases to identify publications from 1946 through December 2023. Studies included reported serum values as prognostic factors for BA after HPE, specifically total bilirubin (TB), alanine transaminase (ALT), gamma‐glutamyl transferase (GGT), matrix metalloproteinase 7 (MMP‐7), and total bile acids (TBA). We defined nonfunctioning HPE as persistent jaundice, cirrhosis, LT, or death. We calculated pooled serum variables, including hazard and odds ratios, for NLS using inverse variance weighting. Results Thirty studies were included in the meta‐analysis including a total of 4399 BA patients, 2073 and 1793 had successful versus nonfunctioning HPE, respectively. The mean HPE age for the successful group was significantly less (63.3 vs. 69.5 days, p 5 years after HPE ( p 5 years after HPE. Conclusion Established serum values ALT, GGT, and TB are useful for prognostic assessment post‐HPE. MMP‐7 and TBA require additional evaluation to determine their prognostic relevance for NLS in BA.
Anouti et al. (Thu,) studied this question.