Ductular reaction and hepatocyte ballooning identify patients with fibrosing cholestatic hepatitits after liver transplantation
Autor: | Carla Montironi, S.S. Sciarrone, Claudia Mescoli, Xavier Forns, Laura-Patricia Llovet, Massimo Rugge, María-Carlota Londoño, Gonzalo Crespo, Patrizia Burra, Alba Díaz, Sergio Rodríguez-Tajes |
---|---|
Rok vydání: | 2020 |
Předmět: |
Male
0301 basic medicine medicine.medical_specialty Histology Time Factors Biopsy Hepatitis C virus medicine.medical_treatment Fibrosing cholestatic hepatitis Liver transplantation medicine.disease_cause Gastroenterology Ballooning 03 medical and health sciences Ballooning degeneration Postoperative Complications 0302 clinical medicine Recurrence Positive predicative value Internal medicine Odds Ratio medicine Humans Retrospective Studies Cholestasis Hepatology medicine.diagnostic_test business.industry Gold standard (test) Middle Aged Ductular reaction Hepatitis C Liver Transplantation 030104 developmental biology Liver Liver biopsy Hepatocytes Female 030211 gastroenterology & hepatology Bile Ducts business |
Zdroj: | Gastroenterología y Hepatología. 43:14-21 |
ISSN: | 0210-5705 |
Popis: | Introduction Diagnosis of severe hepatitis C recurrence is based on analytical and histological criteria but there is little information about their correlation. Aim To assess the accuracy of laboratory criteria for the diagnosis of fibrosing cholestatic hepatitis (FCH). Patients and methods Retrospective analysis of prospectively collected data form HCV positive patients who underwent liver transplantation (LT) between 2000 and 2014 in two European university hospitals. Patients were classified according to laboratory criteria such as FCH, cholestatic hepatitis (CH) and non-cholestatic acute hepatitis (NCAH). Histological characteristics were also evaluated. Results Seventy patients with acute HCV recurrence within the first year after LT with an available liver biopsy were included in the study. Most patients were male (70%) with a median age of 58 years (50–64) and infected with genotype 1b (71.4%). Median time from LT to diagnosis of recurrence was 2.96 months (2.1–5.3). Thirty-nine patients were classified as FCH, 21 as CH and 10 as NCAH. Marked hepatocyte ballooning and ductular reaction were associated with the presence of FCH with an OR of 4.66 (p = 0.047) and 20.58 (p = 0.025), respectively. Considering liver biopsy as the gold standard, the sensitivity, specificity, positive and negative predictive values of the analytical criteria were 0.8, 0.5, 0.3 and 0.9, respectively. However, correlation between histological and analytical criteria was poor (k = 0.033). Discussion Analytical criteria may be used to rule out the presence of FCH, but a biopsy is mandatory to confirm the diagnosis. Ductular reaction and hepatocyte ballooning were independent predictors of FCH. |
Databáze: | OpenAIRE |
Externí odkaz: |