Comparative allograft histology after liver transplantation for cryptogenic cirrhosis, alcohol, hepatitis C, and cholestatic liver diseases.
Comparative allograft histology after liver transplantation for cryptogenic cirrhosis, alcohol, hepatitis C, and cholestatic liver diseases.
复制标题
隐源性肝硬化、酒精、丙型肝炎和胆汁淤积性肝病肝移植后比较同种异体移植组织学。
DOI：
10.1097/00007890-200007270-00009
复制
发表时间：
2000
期刊：
影响因子：
6.2
通讯作者：
Charlton,MR
中科院分区：
文献类型：
--
作者：
Maor-Kendler,Y;Batts,KP;Burgart,LJ;Wiesner,RH;Krom,RA;Rosen,CB;Charlton,MR
背景：不明原因的终末期肝病（隐源性肝硬化）是肝移植的常见指征。同种异体移植物炎症和纤维化的复发频率相似，肝移植后隐源性肝硬化和丙型肝炎（HCV.Methods.We确定了连续移植后同种异体移植物组织学在四组受体：31移植隐源性肝硬化，70胆汁淤积性病因，40酒精性肝病，56 HCV。结果：在移植后4个月、1年和最近的评估（平均45±17个月），肝纤维化分期和改良肝炎活动指数（HAI）在隐源性受者中≥ 2的发生率与胆汁淤积和酒精性受者相似。对于HCV感染的受者，HAI≥ 2的频率在1年时（52 vs. 29%，P= 0.04）和最近评估时（64 vs. 15%，P= 0.003）高于隐源性受者。隐源性、胆汁淤积性和酒精性受体的纤维化评分在所有时间点均相似。在4个月（29 vs. 12%，P= 0.05）、1年（46 vs. 7%，P = 0.0002）和最近评估时（42 vs. 15%，P= 0.06），HCV感染受者纤维化分期> 2的比例高于隐源性受者。隐源性受体没有发展cirrhosis. Results.The频率升高HAI和纤维化阶段的受体谁接受移植隐源性肝硬化是相似的受体谁接受移植胆汁淤积性病因和显着低于HCV感染的受体。纤维化阶段和HAI在隐源性肝硬化移植后通常是稳定的。这些数据并不表明大多数隐源性肝硬化患者的肝脏疾病的病毒病因。
Background.End-stage liver disease for which no cause can be identified, cryptogenic cirrhosis, is a common indication for liver transplantation. Allograft inflammation and fibrosis have been reported to recur with similar frequencies after liver transplantation for cryptogenic cirrhosis and hepatitis C (HCV).Methods.We determined sequential posttransplant allograft histology in four groups of recipients: 31 transplanted for cryptogenic cirrhosis, 70 for cholestatic etiologies, 40 for alcoholic liver disease, and 56 for HCV. Modified hepatitis activity index (HAI) and fibrosis stage were determined at 4 months, 1 year, and at most recent biopsy posttransplantation.Results.The prevalence of HAI≥ 2 among cryptogenic recipients was similar to that of cholestatic and alcoholic recipients at 4 months, 1 year, and at most recent evaluation (mean 45±17 months posttransplantation). For HCV-infected recipients, the frequency of HAI≥ 2 was more than for cryptogenic recipients at 1 year (52 vs. 29%, P= 0.04) and at most recent evaluation (64 vs. 15%, P= 0.003). Fibrosis scores for cryptogenic, cholestatic, and alcoholic recipients were similar at all timepoints. The proportion of HCV-infected recipients with fibrosis stage> 2 was more than that of cryptogenic recipients at 4 months (29 vs. 12%, P= 0.05), 1 years (46 vs. 7%, P= 0.0002), and at most recent evaluation (42 vs. 15%, P= 0.06). None of the cryptogenic recipients developed cirrhosis.Results.The frequency of elevated HAI and fibrosis stage in recipients who undergo transplantation for cryptogenic cirrhosis is similar to that of recipients who undergo transplantation for cholestatic etiologies and significantly less than that of HCV-infected recipients. Fibrosis stage and HAI are generally stable after transplantation for cryptogenic cirrhosis. These data do not suggest a viral etiology of liver disease in the majority of patients with cryptogenic cirrhosis.