Natural History of Non Cirrhotic Portal Fibrosis - a Tropical Experience

Jayanthi, V.

doi:10.15406/ghoa.2017.06.00185

Cited by 1 publication

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…18 NCPF is usually nonprogressive, although a subset of patients is likely proceed to progressive liver failure with the development of ascites and may even require LT. 19 Excessive iron and copper deposition in liver explants has been noted in earlier studies as well. However, genetic testing for HFE gene mutation was negative in all cases.…”

Section: Discussionmentioning

confidence: 64%

Explant liver evaluation decodes the mystery of cryptogenic cirrhosis!

Jain¹,

Venkataraman²,

Varghese³

et al. 2019

JGH Open

View full text Add to dashboard Cite

Background and Aim To determine the concordance of liver explants with the pretransplant diagnosis. Methods This was a retrospective analysis of 251 liver explants. Patient information included demography, comorbidity, and etiological diagnosis. Final diagnosis was based on morphological and histological findings. For non‐alcoholic steatohepatitis (NASH) and cryptogenic cirrhosis, we investigated comorbid states such as obesity, hypertension, and diabetes. Chi square test and Cohen's Kappa value were used. A P value of <0.05 was considered significant. Results A total of 192 patients (76.5%) were males. A significant concordance of explant diagnosis with pretransplant diagnosis was present in 225 (89.6%) patients. It was 100% for alcohol‐related disease, hepatitis B, hepatitis C, autoimmune (AI) liver disease, biliary cirrhosis, and Budd–Chiari syndrome. Of 37 patients with a pretransplant diagnosis of cryptogenic cirrhosis, major discordance was observed in 23 (62.1%). On explant, seven patients each had hemochromatosis 5 (13.5%), AI hepatitis, and NASH (18.9%); two had noncirrhotic fibrosis (5.4%); and one each had Wilson's disease and congenital hepatic fibrosis (2.7%). Of the 20 explants, 3 with pretransplant diagnosis of NASH had a diagnosis of cryptogenic cirrhosis on explant specimens. Cohen's Kappa for the concordance of pretransplant diagnosis and explant diagnosis in NASH and cryptogenic cirrhosis patients was 0.75 and 0.47, respectively. An incidental hepatocellular carcinoma was picked up in 16 explants, and 18 had granulomas. Conclusion Concordance between pretransplant and explant diagnosis is lower for NASH and cryptogenic cirrhosis. The true prevalence of cryptogenic cirrhosis in our study was 5.6%.

show abstract

Section: Discussionmentioning

confidence: 64%