American Journal of Transplantation 2014; 14: 375–383 Wiley Periodicals Inc.
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Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons doi: 10.1111/ajt.12594
Liver Stiffness 1 Year After Transplantation Predicts Clinical Outcomes in Patients With Recurrent Hepatitis C G. Crespo1,*, S. Lens1, M. Gambato1, ~ o1, M.-C. London ~ o1, J. A. Carrio´n1, Z. Marin 2 1 1 R. Miquel , J. Bosch , M. Navasa and X. Forns1
Received 27 June 2013, revised 21 October 2013 and accepted for publication 14 November 2013
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Liver Unit, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain 2 Pathology Department, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain Corresponding author: Gonzalo Crespo, [email protected]
The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C–infected and 48 non–hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) 0.3 and 6 an success rate < 60%). Thus, the final study population comprised 144 HCV-infected LT recipients with a valid LSM 1 year after LT (Figure 1). Among them, 94 patients had a liver biopsy and 77 patients a liver biopsy (either percutaneous or transjugular) and an HVPG measurement at this time point (12 months) (Figure 1). We evaluated, on the one hand, the population of 144 patients with LSM 1 year after LT and, on the other hand, the subpopulation of 77 patients with the three examinations performed.
Antiviral treatment with pegylated interferon and ribavirin was administered during the first year after LT only in cases of fibrosing cholestatic hepatitis or acute hepatitis with the presence of confluent necrosis. From the first year after LT, the presence of significant fibrosis and/or portal hypertension was the criteria to indicate therapy (9).
Statistical analysis Quantitative variables are expressed as median values (range), and categorical variables as n (%). For categorical variables, differences between groups were assessed using Fisher’s exact test, while differences among quantitative variables were analyzed with a nonparametric test (Mann– Whitney for unpaired samples and Wilcoxon test for paired samples). A twosided p-value of
C
Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons doi: 10.1111/ajt.12594
Liver Stiffness 1 Year After Transplantation Predicts Clinical Outcomes in Patients With Recurrent Hepatitis C G. Crespo1,*, S. Lens1, M. Gambato1, ~ o1, M.-C. London ~ o1, J. A. Carrio´n1, Z. Marin 2 1 1 R. Miquel , J. Bosch , M. Navasa and X. Forns1
Received 27 June 2013, revised 21 October 2013 and accepted for publication 14 November 2013
1
Liver Unit, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain 2 Pathology Department, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain Corresponding author: Gonzalo Crespo, [email protected]
The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C–infected and 48 non–hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) 0.3 and 6 an success rate < 60%). Thus, the final study population comprised 144 HCV-infected LT recipients with a valid LSM 1 year after LT (Figure 1). Among them, 94 patients had a liver biopsy and 77 patients a liver biopsy (either percutaneous or transjugular) and an HVPG measurement at this time point (12 months) (Figure 1). We evaluated, on the one hand, the population of 144 patients with LSM 1 year after LT and, on the other hand, the subpopulation of 77 patients with the three examinations performed.
Antiviral treatment with pegylated interferon and ribavirin was administered during the first year after LT only in cases of fibrosing cholestatic hepatitis or acute hepatitis with the presence of confluent necrosis. From the first year after LT, the presence of significant fibrosis and/or portal hypertension was the criteria to indicate therapy (9).
Statistical analysis Quantitative variables are expressed as median values (range), and categorical variables as n (%). For categorical variables, differences between groups were assessed using Fisher’s exact test, while differences among quantitative variables were analyzed with a nonparametric test (Mann– Whitney for unpaired samples and Wilcoxon test for paired samples). A twosided p-value of
