Khaled Abou el ella
Menoufiya University, Egypt
Title: Liver biopsy is still needed in liver transplantation recipients; single center experience
Biography
Biography: Khaled Abou el ella
Abstract
Background:
Liver transplantation is a final treatment for decompensated liver disease.
Aim:
description of post-liver transplant histopathology.
Methods:
We enrolled 89 patients divided into two groups according to if underwent on demand liver biopsy (n =34; 38.2%) or not (n =55; 61.8%). Albumin-bilirubin (ALBI) score and Model for End-Stage Liver Disease (MELD) assessed the degree of liver dysfunction.
Results:
Patient underwent liver biopsy (LB) were 44.65±8.46 years old, mainly males (88.2%) with average MELD of 8.74±4.71.
Most patients were positive pretransplant for HCV (91.2%) and 29.4% had hepatocellular carcinoma on top of hepatitis C.
Patients underwent LB had worse liver dysfunction by ALBI score (-2.62±0.6 vs. -2.96±0.5; p =0.014) but comparable MELD.
The time till first biopsy was 19.88±11.22 (4-44) months. It was not different statistically with various histopathology (p >0.05). Histopathology of first biopsy was viral chronic hepatitis (50%), acute rejection (20.6%), steatohepatitis (11.8%), chronic rejection (5.9%), chronic hepatitis (5.9%), biliary obstruction (2.9%) and cytomegalovirus hepatitis (2.9%).
Most patients were F1 (38.2%) and A1 (35.3%). The immunosuppressive drug regimen had no impact on the histopathology (p >0.05).
Patients with hepatitis C pretransplant had in a descending manner the following histological diagnosis (p =0.001): viral chronic hepatitis 16(51.6%), acute rejection 7(22.6%), steatohepatitis 4(12.9%), chronic rejection 2 (6.5%), biliary obstruction 1(3.2%) and CMV hepatitis 1(3.2%).
Some patients required on demand second (n=9) and third biopsied (n=5) that were the same as the first biopsy or completely different.
Conclusion:
liver biopsy is a useful tool for diagnosis of liver transplantation complications.