Manousou, P and Dhillon, AP and Isgro, G and Calvaruso, V and Luong, TV and Tsochatzis, E and Xirouchakis, E and Kalambokis, G and Cross, TJ and Rolando, N and O'Beirne, J and Patch, D and Thornburn, D and Burroughs, AK (2011) Digital Image Analysis of Liver Collagen Predicts Clinical Outcome of Recurrent Hepatitis C Virus 1 Year After Liver Transplantation. LIVER TRANSPLANT , 17 (2) 178 - 188. 10.1002/lt.22209.
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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. Liver Transpl 17:178-188, 2011. (C) 2011 AASLD.
|Title:||Digital Image Analysis of Liver Collagen Predicts Clinical Outcome of Recurrent Hepatitis C Virus 1 Year After Liver Transplantation|
|Keywords:||VENOUS-PRESSURE GRADIENT, FIBROSIS PROGRESSION, DONOR AGE, MICROEMULSIFIED CYCLOSPORINE, GASTROESOPHAGEAL VARICES, PORTAL-HYPERTENSION, PROGNOSTIC VALUE, HCV RECURRENCE, CIRRHOSIS, IMMUNOSUPPRESSION|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Medicine (Division of)|
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of) > Research Department of General Surgery
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Wolfson Institute and Cancer Institute Administration > Cancer Institute > Research Department of Pathology
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