Hepatic venous pressure gradient to assess fibrosis and its progression after liver transplantation for HCV cirrhosis

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dc.contributor.authorSamonakis, D. N.en
dc.contributor.authorCholongitas, E.en
dc.contributor.authorThalheimer, U.en
dc.contributor.authorKalambokis, G.en
dc.contributor.authorQuaglia, A.en
dc.contributor.authorTriantos, C. K.en
dc.contributor.authorMela, M.en
dc.contributor.authorManousou, P.en
dc.contributor.authorSenzolo, M.en
dc.contributor.authorDhillon, A. P.en
dc.contributor.authorPatch, D.en
dc.contributor.authorBurroughs, A. K.en
dc.date.accessioned2015-11-24T19:14:11Z
dc.date.available2015-11-24T19:14:11Z
dc.identifier.issn1527-6465-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/21267
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectAgeden
dc.subjectBiopsyen
dc.subject*Blood Pressureen
dc.subjectCarcinoma, Hepatocellular/complicationsen
dc.subjectCohort Studiesen
dc.subjectDisease Progressionen
dc.subjectFemaleen
dc.subjectHepatitis B/complicationsen
dc.subjectHepatitis C/pathology/*surgeryen
dc.subjectHepatitis Delta Virus/isolation & purificationen
dc.subjectHumansen
dc.subjectHypertension, Portal/pathology/*physiopathologyen
dc.subjectImmunosuppressive Agents/therapeutic useen
dc.subjectLiver Cirrhosis/*pathologyen
dc.subjectLiver Neoplasms/complicationsen
dc.subjectLiver Transplantation/*adverse effects/immunology/mortalityen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectPatient Selectionen
dc.subjectRecurrenceen
dc.subjectSurvival Analysisen
dc.titleHepatic venous pressure gradient to assess fibrosis and its progression after liver transplantation for HCV cirrhosisen
heal.abstractProgression 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1002/lt.21227-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/17763383-
heal.identifier.secondaryhttp://onlinelibrary.wiley.com/store/10.1002/lt.21227/asset/21227_ftp.pdf?v=1&t=h0ulz5fw&s=d5a8044c3f79b78e7e53cd3edd4b4606a93a3ac4-
heal.journalNameLiver Transplen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2007-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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