Liver biopsy is essential in the follow-up of Hepatitis C-infected liver transplant recipients.
Dr Alejandro Blasco and colleagues from Spain prospectively compared percutaneous vs transjugular liver biopsy in the assessment of liver damage.
The research team also explored the diagnostic value of hepatic venous pressure gradient.
The team aimed to identify patients at risk of severe Hepatitis C disease recurrence after liver transplantation.
The researchers performed 116 paired percutaneous liver biopsy and transjugular liver biopsy 3 or 12 months after liver transplantation in 80 patients.
Concordance for necroinflammation and fibrosis was fair or good, particularly 1 year after liver transplantation.
|Clinical decompensation occurred in 19% of all patients|
At this point, a significant positive association was seen between the median hepatic venous pressure gradient, and the fibrosis stage.
Despite this strong association, the researchers detected portal hypertension in 1 of 22, 4 of 25, and 6 of 10 patients with fibrosis stages 0, 1, and 2, respectively.
After a median follow-up of 38 months, the researchers observed that clinical decompensation occurred in 19% of all patients.
The presence of significant fibrosis 1 year after transplantation was able to predict clinical decompensation.
However, the team noted that hepatic venous pressure gradient of 6 mm Hg or more was very accurate in identifying patients at risk of disease progression.
Dr Blasco's team concluded, “Hepatic venous pressure gradient determination is a valuable tool for follow-up in patients with Hepatitis C recurrence after liver transplantation.”