Digital image analysis of liver collagen predicts clinical outcome of recurrent hepatitis C virus 1 year after liver transplantation
Φόρτωση...
Ημερομηνία
Συγγραφείς
Manousou, P.
Dhillon, A. P.
Isgro, G.
Calvaruso, V.
Luong, T. V.
Tsochatzis, E.
Xirouchakis, E.
Kalambokis, G.
Cross, T. J.
Rolando, N.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Liver Transpl
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
Clinical outcomes of recurrent hepatitis C virus after liver transplantation are difficult to predict. We evaluated collagen proportionate area (CPA), a quantitative histological index, at 1 year with respect to the first episode of clinical decompensation. Patients with biopsies at 1 year after liver transplantation were evaluated by Ishak stage/grade, and biopsy samples stained with Sirius red for digital image analysis were evaluated for CPA. Cox regression was used to evaluate variables associated with first appearance of clinical decompensation. Receiver operating characteristic (ROC) curves were also used. A total of 135 patients with median follow-up of 76 months were evaluated. At 1 year, median CPA was 4.6% (0.2%-36%) and Ishak stage was 0-2 in 101 patients, 3-4 in 23 patients, and 5-6 in 11 patients. Decompensation occurred in 26 (19.3%) at a median of 61 months (15-138). Univariately, CPA, tacrolimus monotherapy, and Ishak stage/grade at 1 year were associated with decompensation; upon multivariate analysis, only CPA was associated with decompensation (P = 0.010; Exp(B) = 1.169; 95%CI, 1.037-1.317). Area under the ROC curve was 0.97 (95%CI, 0.94-0.99). A cutoff value of 6% of CPA had 82% sensitivity and 95% specificity for decompensation. In the 89 patients with hepatic venous pressure gradient (HVPG) measurement, similar results were obtained. When both cutoffs of CPA > 6% and HVPG >/= 6 mm Hg were used, all patients decompensated. Thus, CPA at 1-year biopsy after liver transplantation was highly predictive of clinical outcome in patients infected with hepatitis C virus who underwent transplantation, better than Ishak stage or HVPG.
Περιγραφή
Λέξεις-κλειδιά
Adolescent, Adult, Aged, Biopsy, Child, Collagen/*metabolism, End Stage Liver Disease/pathology/physiopathology/*surgery/virology, Female, Hepatic Veins/physiopathology, Hepatitis C/complications/metabolism/pathology/physiopathology/*surgery, Humans, *Image Interpretation, Computer-Assisted, Kaplan-Meier Estimate, Liver/blood supply/*metabolism/pathology/*surgery/virology, Liver Cirrhosis/metabolism/pathology/physiopathology/*surgery/virology, Liver Transplantation/*adverse effects, London, Male, Middle Aged, Predictive Value of Tests, Proportional Hazards Models, ROC Curve, Recurrence, Retrospective Studies, Risk Assessment, Risk Factors, Sensitivity and Specificity, Time Factors, Venous Pressure, Young Adult
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/21280191
http://onlinelibrary.wiley.com/store/10.1002/lt.22209/asset/22209_ftp.pdf?v=1&t=h0ulywnc&s=60bca922865a410c028501b6199dd1c5156dc60b
http://onlinelibrary.wiley.com/store/10.1002/lt.22209/asset/22209_ftp.pdf?v=1&t=h0ulywnc&s=60bca922865a410c028501b6199dd1c5156dc60b
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής