Original article—liver, pancreas, and biliary tractHistologic Predictors of Fibrosis Progression in Liver Allografts in Patients With Hepatitis C Virus Infection
Section snippets
Patient Population
This study was approved by the University of Pennsylvania institutional review board. The cohort was composed of all HCV-infected patients who underwent liver transplant at the University of Pennsylvania between 1999 and 2007. During this time, 996 total liver transplants were performed, of which 476 (48%) were in patients with chronic HCV. Twenty-three patients had 2 transplants between 1999 and 2007; disease progression in each transplanted liver was examined independently. Our
Results
The characteristics of our study population are shown in Table 1 and Supplementary Table 1. The same transplant team remained in place during the entire study period, and posttransplant patient and graft survival consistently were above the national average (data not shown). From the 476 transplants performed secondary to HCV cirrhosis, 52 (10.92%) rapid fibrosers and 61 (12.81%) slow fibrosers were identified. The mean follow-up time in years (±standard deviation [SD]) was 2.11 (±1.99) for the
Discussion
In summary, we have performed a large, single-institution, retrospective study of HCV patients posttransplant. We show that the rate of fibrosis on a population basis is constant throughout the posttransplant period and that the course of fibrosis is determined early posttransplant. Although several studies (incorporating patients transplanted from 1988–2002) have shown that the presence or absence of significant fibrosis on a biopsy at 1 year posttransplant was predictive of graft survival and
Acknowledgments
The authors gratefully acknowledge the assistance and contributions of Drs George Makar, Colleen Brensinger, Abraham Shaked, Kim Olthoff, Gerald Wertheim, Sriram Venneti, Rosalyn Diaz, and Helen Zhu.
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by a National Institutes of Health grant (DK-058123 to R.G.W.) and Pathology and Laboratory Medicine intradepartmental grant support (E.E.F.).