Cryptogenic cirrhosis is the leading cause for listing for liver transplantation in Sri Lanka

Siriwardana, R. C.; Niriella, Madunil Anuk; Liyanage, C.A.H.; Wijesuriya, S.R.E.; Gunathilaka, B.; Dassanayake, Anuradha S; Silva, H. J. De

doi:10.1007/s12664-013-0376-4

Cited by 18 publications

(24 citation statements)

References 9 publications

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“…8 We previously reported that 63% of cases referred for liver transplantation were related to NASH-cirrhosis. 9 We also reported that 59% of the hepatocellular carcinomas were secondary to cryptogenic or NASH-cirrhosis. 10 Large percentages (45%) of our liver donors are rejected as a result of the presence of NAFLD.…”

Section: Introductionmentioning

confidence: 87%

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Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans

Niriella

Pathmeswaran

Silva

et al. 2017

Liver International

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Section: Introductionmentioning

confidence: 87%

“…Instead, alcoholic and cryptogenic or NASH‐related forms of cirrhosis predominate . We previously reported that 63% of cases referred for liver transplantation were related to NASH‐cirrhosis . We also reported that 59% of the hepatocellular carcinomas were secondary to cryptogenic or NASH‐cirrhosis .…”

Section: Introductionmentioning

confidence: 98%

Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans

Niriella

Pathmeswaran

Silva

et al. 2017

Liver International

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“…Hepatitis B and C are extremely rare. The majority of the cases are related to NAFLD [6,7] . Others are either alcohol related or the result of a combination of both aetiologies.…”

Section: Introductionmentioning

confidence: 99%

Association of Serum Ferritin with Diabetes and Alcohol in Patients with Non-Viral Liver Disease-Related Hepatocellular Carcinoma

Siriwardana¹,

Niriella²,

Dassanayake³

et al. 2017

Liver Cancer

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Introduction: Non-alcoholic fatty liver disease is a leading cause for hepatocellular carcinoma (HCC) in Sri Lanka. Diabetes mellitus, alcohol abuse, and liver inflammation are known to increase the risk of HCC. The present study evaluates serum ferritin levels in a cohort of patients with non-viral HCC (nvHCC). Methodology: Consecutive patients with nvHCC presenting to the Colombo North Liver transplant Service, Ragama, from January 2012 to July 2013 were investigated. All were negative for hepatitis B and C. At registration, 5 mL of serum was separated into plain tubes, stored at -80 ° C and analysed for ferritin using an enzyme-linked immunosorbent assay. Correlation between the serum ferritin and patient risk factors, liver status, and tumour characteristics were analysed. Results: There were 93 patients with nvHCC (median age 65 [12-82] years; 82 [88.2%] males). The median ferritin level was 246.2 μg/L, and 38 (40.86%) patients had elevated ferritin. Non-diabetics (median 363.5 mg/L, p = 0.003) and alcohol abusers (median 261.2 mg/L, p = 0.018) had higher ferritin levels. On multiple-variable analysis, being non-diabetic ( p = 0.013) and alcoholic ( p = 0.046) was significantly associated with high serum ferritin. No association was found with body mass index, tumour stage, size, macrovascular invasion, number of nodules, alpha-fetoprotein, bilirubin, international normalized ratio, and survival. Conclusion: In patients with nvHCC, serum ferritin levels are higher in non-diabetics and alcoholics.

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“…Previous studies on nonalcoholic fatty liver disease and cirrhosis from Sri Lanka have shown that nonalcoholic fatty liver disease is common (a prevalence of >30% in adults in an urban population) and that cryptogenic cirrhosis (probably related to NASH) is a leading cause of cirrhosis and referral for liver transplantation [7,8,14] . In this study, high alcohol consumption was significantly more common in patients with diffuse HCC.…”

Section: Discussionmentioning

confidence: 99%

“…In Sri Lanka, hepatitis B and C are uncommon. Most of our cirrhotic diseases are related to alcoholic or nonalcoholic steatohepatitis (NASH) or a combination of both [7,8] . With this background, we have noticed that a larger proportion of our HCC are diffuse in type.…”

Section: Introductionmentioning

confidence: 99%

Diffuse-Type Hepatoma: A Grave Prognostic Marker

Siriwardana

Liyanage

Gunetilleke

et al. 2017

Gastrointest Tumors

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Background: Data on diffuse-type hepatocellular carcinoma (HCC) are rare. HCC in Sri Lanka is rising, and the majority is related to nonalcoholic fatty liver disease. This study was planned to compare nodular- and diffuse-type HCC in this cohort. Methods: CT scans of 227 patients with HCC negative for infective hepatitis were analyzed and grouped as nodular and diffuse from July 2011 to July 2014. Diffuse-type cancer was defined as a tumor without convex/distinct margin, diffusely infiltrating the hepatic parenchyma. There were 45 (20%) cases. The baseline liver functions, etiology, treatment, and the outcome were compared with nodular-type cancers. Stage III diffuse cancers were matched with 2 stage III nodular cancers looking at the T stage and background liver. Results: There was no difference in the age (63 vs. 62 years, p = 0.937) and gender. Diffuse cancers had a low BMI (24 vs. 22, p = 0.009), a higher alpha fetoprotein (AFP) level (p < 0.001), a higher incidence of major vascular invasion (14 vs. 80%, p < 0.001), and a history of significant alcohol consumption (39 vs. 67%, p = 0.001). The baseline liver functions were similar in diffuse and nodular cancers. A large proportion (27 vs.77%, p < 0.001) of diffuse cancers were not candidates for active treatment. Overall survival was poor in the diffuse type (4.7 vs. 25 months, p < 0.001). Diffuse-type stage III cancers had a poor survival compared to matched nodular cancers (2.5 vs. 15.8 months, p = 0.001). Conclusion: HCC without a background of infective hepatitis were common in our cohort. These tumors are associated with high AFP levels, major vascular invasion, and a poor prognosis.

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Cryptogenic cirrhosis is the leading cause for listing for liver transplantation in Sri Lanka

Cited by 18 publications

References 9 publications

Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans

Incidence and risk factors for non‐alcoholic fatty liver disease: A 7‐year follow‐up study among urban, adult Sri Lankans

Association of Serum Ferritin with Diabetes and Alcohol in Patients with Non-Viral Liver Disease-Related Hepatocellular Carcinoma

Diffuse-Type Hepatoma: A Grave Prognostic Marker

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