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Clinical value and safety of liver biopsies in patients transplanted for hepatitis C virus‐related end‐stage liver disease
Author(s) -
Brauner C.,
Lankisch T.O.,
Fytili P.,
Jaroszewicz J.,
Lehner F.,
BargHock H.,
Klempnauer J.,
Jaeckel E.,
Manns M.P.,
Wedemeyer H.,
Negm A.A.
Publication year - 2014
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12310
Subject(s) - medicine , liver biopsy , biopsy , gastroenterology , liver disease , hepatitis c virus , liver transplantation , hepatitis c , bilirubin , hepatitis , albumin , transplantation , immunology , virus
Background Hepatitis C is the leading indication for liver transplantation. Differentiation between recurrent graft hepatitis C ( RGH ‐C) and graft rejection ( GR ) is challenging. Liver biopsy is standard to diagnose both conditions; however, little information is available regarding this procedure in hepatitis C virus ( HCV )‐infected liver transplant recipients. Methods Liver biopsies ( n = 211) from all consecutive patients ( n = 138) transplanted for hepatitis C at Hannover Medical School between January 2000 and October 2011 were screened, and a final cohort of 96 patients with 196 biopsies was included. Indications, histopathological findings, and biopsy‐related complications were documented. Modifications in the treatment based on the biopsy result and the biochemical outcome were analyzed. Results Most biopsies (196/211, 93%) were representative. Five patients (2.5%) developed non‐fatal biopsy‐related complications. Biopsy results were GR (35%), RGH ‐C (31%), and other diagnoses (34%). GR was independently associated with lower albumin ( P = 0.025) and higher bilirubin levels ( P = 0.011). Treatment was modified based on the biopsy result in 25% of cases. Alanine aminotransferase ( ALT ), gamma‐glutamyl transferase (GGT), and bilirubin levels improved in 41%, 25%, and 31% of cases 4 weeks post biopsy respectively. ALT improvements were more significant in patients with GR than in those with RGH ‐C. Conclusion Liver biopsy in HCV ‐infected liver transplant recipients is safe and representative in >90% of cases. GR is independently associated with lower albumin and higher bilirubin levels.