Liver fibrosis progression learn more is extremely accelerated

after LT, and graft cirrhosis develops in a significant proportion of patients within the first years.2–4 Early histological damage and increased HVPG values, only 1 year after transplantation, correlate with long-term outcome and identify patients with severe hepatitis C recurrence.10, 13 Patients with significant fibrosis and particularly with portal hypertension 1 year after LT have a high probability of clinical decompensation and graft loss. For this reason, in the current study, patients were classified using both liver biopsy and HVPG, to identify patients with slow or rapid disease progression. In addition, liver stiffness determination has recently been shown to be an excellent noninvasive method to identify patients with significant fibrosis and is even more accurate to diagnose patients with portal hypertension.23 In the present study, the diagnostic accuracy of liver stiffness increased with time. The accuracy to identify rapid fibrosers was poor at 3 months, good at 6 and 9 months, and excellent at 12 months after LT, especially in patients with portal hypertension. Actually, we have previously shown that LSM at 1 year after LT is very accurate to identify significant fibrosis and has an excellent correlation

with selleck products HVPG values to diagnose portal hypertension.23 On the other hand, the current study shows that LSM at 3 months after LT is not useful in the prediction of the different patterns of HCV recurrence. At this early time, MCE公司 fibrosis deposition is probably too low to affect

liver stiffness determination. Moreover, other complications which are frequent during the first months following LT (acute hepatitis, acute rejection, or vascular or biliary problems) might influence liver stiffness independently of the degree of liver fibrosis.32–35 Six months appears to be an important time point for LSM for two reasons: first, the accuracy is high enough to discriminate patients with severe recurrence from those with mild recurrence; second, antiviral treatment at this time could probably decrease or even interrupt fibrosis progression in patients with severe hepatitis C recurrence. Therefore, we sought to increase the diagnostic accuracy of liver stiffness by developing fibrosis—and HVPG—scores at this time point. The variables selected in the estimation group by the multivariate regression model were donor age, LSM, and bilirubin at 6 months. Donor age appeared as an important factor influencing HCV recurrence. Several studies have pointed out the importance of this variable in the severity of HCV recurrence.36, 37 In addition, recipients who develop severe HCV-induced graft damage have significantly higher aminotransferases and bilirubin levels than patients with milder forms.4 The fibrosis score cutoff of −1.99 identified 63% of slow fibrosers with a high NPV of 86%. Interestingly, values higher than −1.