Serum Aspartate Aminotransferase Level and Previous Histopathological Findings Enable Reduction of Protocol Liver Biopsies after Liver Transplantation for Hepatitis C

Tomohiro Tanaka; George Therapondos; Nazia Selzner; Eberhard L Renner; Leslie B Lilly

doi:10.1155/2013/904636

Back

Serum Aspartate Aminotransferase Level and Previous Histopathological Findings Enable Reduction of Protocol Liver Biopsies after Liver Transplantation for Hepatitis C

Journal article

Open access

Serum Aspartate Aminotransferase Level and Previous Histopathological Findings Enable Reduction of Protocol Liver Biopsies after Liver Transplantation for Hepatitis C

Tomohiro Tanaka, George Therapondos, Nazia Selzner, Eberhard L Renner and Leslie B Lilly

Canadian journal of gastroenterology, Vol.27(3), pp.131-136

2013

DOI: 10.1155/2013/904636

PMCID: PMC3732150

PMID: 23516677

Files and links (1)

url

https://doi.org/10.1155/2013/904636View

Published (Version of record) Open Access

Abstract

BACKGROUND: Hepatitis C virus (HCV) infection remains the leading indication for liver transplantation (LT) worldwide. Recurrent hepatitis C following LT is universal, and significant fibrosis (SF, Metavir fibrosis stage ≥2) apparent on protocol biopsy typically prompts antiviral therapy.OBJECTIVE: To determine the optimal timing of protocol liver biopsies in this setting.METHODS: A total of 151 patients who underwent LT related to HCV infection between July 2004 and December 2009 were analyzed retrospectively. Data regarding protocol liver biopsies at six, 12 and 24 months post-LT, conventional laboratory parameters and demographic information were obtained.RESULTS: The 151 patients included in the present study had significantly lower serum aspartate aminotransferase (AST) levels than the four patients who progressed to receive antiviral treatment for SF before six months post-LT (P<0.001). AST level, but not alanine aminotransferase level, histological activity or fibrosis stage at the six-month biopsy was independently associated with the progression to SF at 12 months (P<0.05). However, AST level, histological activity and fibrosis stage at the 12-month biopsy emerged as independent parameters associated with progression to SF at 24 months (P<0.05).CONCLUSION: The protocol liver biopsy at six months could be eliminated, especially in patients who consistently exhibit low AST levels. Histological activity, the presence or absence of fibrosis, and AST values at the 12-month biopsy may lead to the decision to defer the protocol biopsy at 24 months or result in earlier introduction of antiviral therapy.

Details

Title: Subtitle: Serum Aspartate Aminotransferase Level and Previous Histopathological Findings Enable Reduction of Protocol Liver Biopsies after Liver Transplantation for Hepatitis C
Creators: Tomohiro Tanaka - Liver Transplant Unit/Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
George Therapondos - Liver Transplant Unit/Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
Nazia Selzner - Liver Transplant Unit/Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
Eberhard L Renner - Liver Transplant Unit/Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
Leslie B Lilly - Liver Transplant Unit/Multi-Organ Transplant Program, University Health Network, University of Toronto, Toronto, Ontario, Canada
Resource Type: Journal article
Publication Details: Canadian journal of gastroenterology, Vol.27(3), pp.131-136
DOI: 10.1155/2013/904636
PMID: 23516677
PMCID: PMC3732150
NLM abbreviation: Can J Gastroenterol
ISSN: 0835-7900
eISSN: 1916-7237
Language: English
Date published: 2013
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094731902771

Metrics

16 Record Views

2 Times Cited - Web of Science