Hepatic venous pressure gradient to assess fibrosis and its progression after liver transplantation for HCV cirrhosis
Φόρτωση...
Ημερομηνία
Συγγραφείς
Samonakis, D. N.
Cholongitas, E.
Thalheimer, U.
Kalambokis, G.
Quaglia, A.
Triantos, C. K.
Mela, M.
Manousou, P.
Senzolo, M.
Dhillon, A. P.
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
Progression of fibrosis following recurrent hepatitis C virus (HCV) infection is frequent after liver transplantation (LT). Histology remains the gold standard to assess fibrosis, but the value of hepatic venous pressure gradient (HVPG) is being explored. We evaluated patients with recurrent HCV infection after LT to assess whether HVPG correlates with liver histology, particularly fibrosis. A total of 90 consecutive patients underwent 170 HVPG measurements concomitant with transjugular liver biopsy (TJB), with 31.5 (range, 6-156) months of follow up. Median biopsy length was 22 mm and total portal tract count was 12 (complete 6, partial 6). Median HVPG was 4 mmHg: 38% of patients > or =6 mmHg (portal hypertension, PHT), 13% > or =10 mmHg. HVPG correlated with Ishak stage (r = 0.73, P < 0.001) for mild (0-3) and severe fibrosis (4-6), and grade score (r = 0.47, P < 0.001), but neither correlated with interval from LT nor biopsy length. HVPG was > or =10 mmHg in 15 patients: 12 had stage 5 or 6, and 3 severe portal expansion. HVPG was repeated in 49, between 7 and 60 months with weak correlation to fibrosis score (r = 0.30, P = 0.045). A total of 12 patients with HVPG > or =6 mmHg had fibrosis score < or =3, while 8 patients had normal HVPG but fibrosis stage > or =4. These discrepancies were mostly associated with specific histological features such as perisinusoidal fibrosis rather than errors in measuring HVPG. In 29 with HVPG <6 mmHg at 1 yr, none decompensated compared to 4 of 13 (31%) with PHT. In conclusion, HVPG correlates with fibrosis and its progression, due to recurrent HCV infection, assessed in TJB.
Περιγραφή
Λέξεις-κλειδιά
Adult, Aged, Biopsy, *Blood Pressure, Carcinoma, Hepatocellular/complications, Cohort Studies, Disease Progression, Female, Hepatitis B/complications, Hepatitis C/pathology/*surgery, Hepatitis Delta Virus/isolation & purification, Humans, Hypertension, Portal/pathology/*physiopathology, Immunosuppressive Agents/therapeutic use, Liver Cirrhosis/*pathology, Liver Neoplasms/complications, Liver Transplantation/*adverse effects/immunology/mortality, Male, Middle Aged, Patient Selection, Recurrence, Survival Analysis
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/17763383
http://onlinelibrary.wiley.com/store/10.1002/lt.21227/asset/21227_ftp.pdf?v=1&t=h0ulz5fw&s=d5a8044c3f79b78e7e53cd3edd4b4606a93a3ac4
http://onlinelibrary.wiley.com/store/10.1002/lt.21227/asset/21227_ftp.pdf?v=1&t=h0ulz5fw&s=d5a8044c3f79b78e7e53cd3edd4b4606a93a3ac4
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