APRI and FIB-4 Scores Are Useful After Liver Transplantation Independently of Etiology

Pissaia, Alcindo; Borderie, Didier; Denis, Bernard; Scatton, Olivier; Calmus, Yvon; Conti, Filoména

doi:10.1016/j.transproceed.2008.12.014

Cited by 33 publications

(33 citation statements)

References 18 publications

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“…The group found that APRI and FIB-4 significantly correlated with the histologic stage of liver fibrosis regardless of the cause. 12 Toniutto and associates evaluated the role of APRI and AST/ALT ratio and other markers in detecting significant fibrosis (defined as Ishak > 2) in liver transplant patients with HCV. They found that APRI and AST/ALT ratio had a good AUC of 0.801 and 0.785, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…These simple scores have been well studied in chronic liver disease; however, conflicting data exist about their usefulness to assess fibrosis in liver transplant patients. [9][10][11][12] The NAFLD fibrosis score (NFS) was developed to assess fibrosis stage exclusively in patients with NAFLD and has been validated in multiple cohorts. However, its utility after OLT for NAFLD to predict graft fibrosis has not been well studied.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Untitled

Kabbany

Selvakumar²,

Guirguis³

et al. 2018

Exp Clin Transplant

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Objectives: Several scoring systems have been developed to noninvasively predict the presence of advanced fibrosis in patients with chronic liver disease. Hepatitis C virus and nonalcoholic fatty liver disease are the 2 most common indications for orthotopic liver transplant and are associated with disease recurrence that can lead to fibrosis progression. Here, we evaluated the performance of commonly used fibrosis scores in assessing the presence of advanced fibrosis in patients after orthotopic liver transplant. Materials and Methods: Our study consisted of consecutive patients with hepatitis C virus or nonalcoholic fatty liver disease who underwent a liver biopsy after transplant and had laboratory measurements within 1 week of biopsy. Graft fibrosis was determined by an experienced pathologist (stage F0-F4). Advanced fibrosis was defined as stage F3-F4. The following fibrosis scores were calculated for each patient: aspartate aminotransferase/alanine aminotransferase ratio, aspartate aminotransferase/platelet ratio index, and fibrosis-4 index. Results: We analyzed 93 patients with median age of 59 years (25th and 75th percentile of 53 and 64 y) and median body mass index of 31.8 kg/m 2 (25th and 75th percentile of 27 and 37.6 kg/m 2 ). Of total patients, 41 (44%) were diabetic. Median time to liver biopsy posttransplant was 27.7 months (25th and 75 percentile of 10.8 and 59.9 mo). We found that 54 patients (58%) had no fibrosis, 15 (16.1%) had F1, 8 (8.6%) had F2, 7 (7.5%) had F3, and 9 (9.7%) had F4. Overall, advanced fibrosis (F3-F4) was present in 16 patients. Aspartate aminotransferase/alanine aminotransferase ratio, aspartate aminotransferase/platelet ratio index, and fibrosis-4 index were not significantly different between patients with and without advanced fibrosis (all P > .05). The calculated fibrosis scores had poor diagnostic accuracy for presence of advanced fibrosis posttransplant. Conclusions: Commonly used liver fibrosis scores are not accurate in predicting the presence of advanced fibrosis in patients after liver transplant.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Untitled

Kabbany

Selvakumar²,

Guirguis³

et al. 2018

Exp Clin Transplant

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“…Additional labs obtained at baseline and throughout therapy included FK levels, quantitative HIV RNA, CD4+ T-cell counts, liver chemistries, hemoglobin, platelet counts, creatinine and INR. APRI (aspartate transaminase-to-platelet ratio index) and FIB-4 (Fibrosis-4) scores were calculated using standard methodologies [10–13]. …”

Section: Methodsmentioning

confidence: 99%

Successful sofosbuvir-based therapy in HIV/hepatitis C virus coinfected liver transplant recipients with recurrent hepatitis C virus infection

Grant

Hawkins

Brooks

et al. 2016

Aids

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Objective Recurrent hepatitis C virus (HCV) infection contributes to unfavorable outcomes in HIV/HCV co-infected liver transplant (LT) recipients. Direct-acting antiviral (DAA) therapies for HCV offer an opportunity to improve patient and allograft survival in this patient population. We evaluated treatment outcomes with sofosbuvir-based DAA therapy among HIV/HCV co-infected LT recipients. Design Single center prospective cohort study Methods We identified 8 HIV/HCV co-infected LT recipients who were prospectively followed in the Northwestern University Viral Hepatitis Registry and who received sofosbuvir (SOF)-based DAA therapy. We evaluated responses to therapy, including sustained HCV viral response 12 weeks after therapy completion (SVR12) and adverse effects (AE). Results Seven recipients (87.5%) completed 12 weeks of SOF-based therapy: SOF/simeprevir for genotype 1 (n=6), SOF/ribavirin for genotype 2 (n=1). Of persons who completed therapy, all achieved SVR12. Strategies for the management of expected and observed drug interactions consequent to the addition of simeprevir to pre-existing complex medication regimens included modifications of HIV antiretroviral regimens (n=4) and tacrolimus (FK) dosing (n=4) and frequent monitoring of FK trough levels. Minor AEs were observed after DAA initiation. One episode of allograft rejection and one death occurred that were deemed unlikely related to HCV therapy. Conclusions High rates of HCV treatment success and no treatment-limiting AEs were observed in this HIV/HCV LT cohort. Complex drug interactions were successfully managed in the context of multidisciplinary specialty care. Further studies are needed to assess the long-term effects of DAA therapy on patient and allograft survival among HIV/HCV co-infected LT recipients.

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“…Laboratory tests were performed to determine transaminases, cholestasis enzymes and simple validated fibrosis scores (APRI) [35][36][37] . Additionally, 20 mL of blood were obtained to determine serum biomarkers of fibrosis that had been identified in previous studies [38][39][40][41][42] .…”

Section: Clinical and Laboratory Variablesmentioning

confidence: 99%