Correlation Between Fibroscan, Liver Biopsy, and Clinical Liver Function in Patients With Hepatitis C Virus Infection After Renal Transplantation

Muñoz, Raquel; Ramírez, E.; Fernández, Inmaculada; Martín, Alejandro Herrero-San; Romero, María Teresa Cedena; Romero, E; Domínguez‐Gil, Beatriz; Hernández, G. García; Morales, Enrique; Andrès, Axel; Castellano, Giancarlo; Morales, José

doi:10.1016/j.transproceed.2009.06.103

Cited by 24 publications

(15 citation statements)

References 4 publications

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“…This was similar to a study carried out by Rohit and his colleagues where there was significant correlation between LSM and histological fibrosis (r = 0.58, P < 0.001) (13). In contrast, patients with high fibroscan scores (n = 6; >11 kPa) showed a severe form of liver fibrosis with CLD and portal hypertension from a clinical point of view in a study carried out by Mun˜oz R and his colleagues (14).…”

Section: Discussionmentioning

confidence: 97%

Prospective comparison of transient elastography and liver biopsy for the assessment of fibrosis in chronic hepatitis C infection

Abdelmaksoud

Taha

Kassas

et al. 2015

The Egyptian Journal of Radiology and Nuclear Medicine

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HCV is a worldwide problem and the need to assess the degree of fibrosis is the corner stone in its treatment. Liver biopsy has been used for years to assess the degree of fibrosis and activity but recently many non-invasive methods have emerged to replace it as aspartate transaminase/platelet ratio [APRI), abdominal ultrasonography measuring caudate/right lobe ratio and hepatic stiffness [Fibroscan). Purpose: Correlate the accuracy of Transient Elastography [Fibroscan) in comparison to liver biopsy as a non-invasive method for fibrosis assessment in chronic hepatitis C patients. Methods: The study was done on 50 patients with chronic HCV [32 males and 18 females) for which liver biopsy and fibroscan were performed. Results: There was positive correlation of liver biopsy with fibroscan score, there was moderate agreement [matching) between liver biopsy and fibroscan the lowest matching were in F0 and the highest were in F3. Conclusion: Fibroscan has a good matching with liver biopsy in the detection of hepatic fibrosis and follow up of its progression.

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Section: Discussionmentioning

confidence: 97%

Prospective comparison of transient elastography and liver biopsy for the assessment of fibrosis in chronic hepatitis C infection

Abdelmaksoud

Taha

Kassas

et al. 2015

The Egyptian Journal of Radiology and Nuclear Medicine

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“…These non-invasive tests have not been validated either in patients with chronic HBV infection or in solid organ transplant recipients [52][53][54][55]. In our experience, the diagnostic accuracy of biochemical noninvasive markers including Fibrotest, Apri, Forns or FIB-4 index is still not enough to avoid a liver biopsy in most patients.…”

Section: Non-invasive Evaluation Of Fibrosismentioning

confidence: 96%

“…Serial evaluation of the impact of hepatitis on the liver (stage and grade) is mandatory in allograft recipients. A liver biopsy [50,51] and biochemical or morphological non-invasive tests (such as elastometry) may be performed for fibrosis evaluation, although further studies are required to confirm the relevance of the latter procedures in this setting [52][53][54][55].…”

Section: New Conceptsmentioning

confidence: 99%

VIRAL hepatitis in solid organ transplantation other than liver

Vallet-Pichard¹,

Fontaine²,

Mallet³

et al. 2011

Journal of Hepatology

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Transplantation is the best treatment for end-stage organ failure. Hepatitis virus infections, mainly hepatitis B virus (HBV) and hepatitis C virus (HCV) infections still constitute a major problem because they are common in allograft recipients and are a significant cause of morbidity and mortality after transplantation. Recently, hepatitis E virus infection has been added as an emergent cause of chronic hepatitis in organ transplantation. The prevalence of HBV and HCV infections has markedly decreased in patients who are candidates for transplantation since the introduction of screening, hygiene and prevention measures, including systematic screening of blood and organ donations, use of erythropoietin, compliance with universal hygiene rules, segregation of HBV-infected patients from non-infected patients and systematic vaccination against HBV. A liver biopsy is preferable to non-invasive biochemical and/or morphological tests of fibrosis to evaluate liver fibrosis before and even after transplantation. Treatment with entecavir or tenofovir is indicated in HBV-infected dialyzed patients who have moderate or severe disease (≥A2 or F2 on the Metavir scale) in preparation for renal transplantation. Due to the risks of severe reactivation, fibrosing cholestatic hepatitis or histological deterioration after transplantation, systematic use of nucleoside or nucleotide analogues shortly before or at the time of transplantation is recommended (tenofovir or entecavir are preferable to lamivudine) in all patients, whatever the baseline histological evaluation. In HCV-infected dialyzed patients who are not candidates for renal transplantation, the indication for antiviral therapy is limited to significant fibrosis (fibrosis ≥2 on the Metavir scale). Treatment must be proposed to all candidates for renal transplantation, whatever their baseline histopathology, and interferon-α should be used as monotherapy. After transplantation, interferon-α is contraindicated but may be used in patients for whom the benefits of antiviral treatment clearly outweigh the risks, especially that of allograft rejection. All cirrhotic patients, notably after solid organ transplantation, should be screened for hepatocellular carcinoma. Sustained suppression of necro-inflammation may result in regression of cirrhosis, which in turn may lead to decreased disease-related morbidity and improved survival. Finally, due to the high mortality after renal transplantation, active (namely without sustained viral suppression) cirrhosis should be considered a contraindication to kidney transplantation, but an indication to combined liver-kidney transplantation; on the contrary, inactive (namely with sustained viral suppression) compensated cirrhosis may permit renal transplantation alone. Organ transplantations other than kidney (cardiac or pulmonary transplantations) involve the same diagnosis and therapeutic issues.

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“…With an APRI ratio cut-off >0.95, the positive predictive value was 66% (identifying patients with cirrhosis) [40]. Regarding hepatic elastography, a single study has demonstrated a good correlation between liver stiffness and fibrosis stage on histology in 22 HCV+renal transplant recipients [41].…”

Section: Assessment Of Liver Disease Severitymentioning

confidence: 99%

Management of Hepatitis C in Patients with Chronic Kidney Disease

Al-Freah

Zeino

Heneghan

2011

Curr Gastroenterol Rep

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Chronic kidney disease represents a global health problem. Chronic hepatitis C virus (HCV) infection is prevalent in patients with end stage renal disease (ESRD) on hemodialysis (HD) and in renal transplant recipients with significant impact on morbidity and mortality. Furthermore, HCV can cause various forms of glomerulopathy with the predominant type being cryglobulinemia associated membranoproliferative glomerulonephritis. Liver enzymes are traditionally used as markers of liver injury; however, there is wide variation in aminotransferase levels in patients with ESRD. Therefore, diagnosis of chronic hepatitis C (CHC) in patients with ESRD is based on HCV antibody testing and further confirmation with polymerase chain reaction testing. Current standard therapy for CHC is composed of pegylated interferon and ribavirin. However, this combination is challenging in patients with ESRD due to its tolerability. We describe in this review relevant issues in epidemiology, diagnosis and management of CHC in ESRD, HD and renal transplant recipients.

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Correlation Between Fibroscan, Liver Biopsy, and Clinical Liver Function in Patients With Hepatitis C Virus Infection After Renal Transplantation

Cited by 24 publications

References 4 publications

Prospective comparison of transient elastography and liver biopsy for the assessment of fibrosis in chronic hepatitis C infection

Prospective comparison of transient elastography and liver biopsy for the assessment of fibrosis in chronic hepatitis C infection

VIRAL hepatitis in solid organ transplantation other than liver

Management of Hepatitis C in Patients with Chronic Kidney Disease

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