Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients
Background and Aims. Serum fibrosis biomarkers have shown good accuracy in the liver transplant (LT) population. We employed a simple serum biomarker to elucidate incidence and predictors of advanced fibrosis after LT over a long follow-up period. Methods. We included 440 consecutive patients who un...
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| Format: | Article |
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Wiley
2017-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2017/4381864 |
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| author | Mamatha Bhat Kathleen C. Rollet-Kurhajec Aparna Bhat Amanda Farag Marc Deschenes Philip Wong Peter Ghali Giada Sebastiani |
| author_facet | Mamatha Bhat Kathleen C. Rollet-Kurhajec Aparna Bhat Amanda Farag Marc Deschenes Philip Wong Peter Ghali Giada Sebastiani |
| author_sort | Mamatha Bhat |
| collection | DOAJ |
| description | Background and Aims. Serum fibrosis biomarkers have shown good accuracy in the liver transplant (LT) population. We employed a simple serum biomarker to elucidate incidence and predictors of advanced fibrosis after LT over a long follow-up period. Methods. We included 440 consecutive patients who underwent LT between 1991 and 2013. Advanced liver fibrosis was defined as FIB-4 > 3.25 beyond 12 months after LT. Results. Over 2030.5 person-years (PY) of follow-up, 189 (43%) developed FIB-4 > 3.25, accounting for an incidence of 9.3/100 PY (95% confidence interval [CI], 8.1–10.7). Advanced fibrosis was predicted by chronic HCV infection (adjusted hazard ratio (aHR) = 3.96, 95% CI 2.92–5.36, p < 0.001), hypoalbuminemia (aHR = 2.31, 95% CI 1.72–3.09; p < 0.001), and hyponatremia (aHR = 1.48, 95% CI 1.09–2.01; p = 0.01). LT recipients with more than 1 predictor had a higher incidence of advanced fibrosis, the highest being when all 3 predictors coexisted (log-rank: p < 0.001). Conclusions. Chronic HCV infection, hypoalbuminemia, and hyponatremia predict progression to advanced liver fibrosis following LT. Patients with these risk factors should be serially monitored using noninvasive fibrosis biomarkers and prioritized for interventions. |
| format | Article |
| id | doaj-art-89aaba9540994712a93b7a69ca640dc2 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-89aaba9540994712a93b7a69ca640dc22025-02-03T07:25:10ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972017-01-01201710.1155/2017/43818644381864Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant RecipientsMamatha Bhat0Kathleen C. Rollet-Kurhajec1Aparna Bhat2Amanda Farag3Marc Deschenes4Philip Wong5Peter Ghali6Giada Sebastiani7Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaChronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaDivision of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Centre, Montreal, QC, CanadaBackground and Aims. Serum fibrosis biomarkers have shown good accuracy in the liver transplant (LT) population. We employed a simple serum biomarker to elucidate incidence and predictors of advanced fibrosis after LT over a long follow-up period. Methods. We included 440 consecutive patients who underwent LT between 1991 and 2013. Advanced liver fibrosis was defined as FIB-4 > 3.25 beyond 12 months after LT. Results. Over 2030.5 person-years (PY) of follow-up, 189 (43%) developed FIB-4 > 3.25, accounting for an incidence of 9.3/100 PY (95% confidence interval [CI], 8.1–10.7). Advanced fibrosis was predicted by chronic HCV infection (adjusted hazard ratio (aHR) = 3.96, 95% CI 2.92–5.36, p < 0.001), hypoalbuminemia (aHR = 2.31, 95% CI 1.72–3.09; p < 0.001), and hyponatremia (aHR = 1.48, 95% CI 1.09–2.01; p = 0.01). LT recipients with more than 1 predictor had a higher incidence of advanced fibrosis, the highest being when all 3 predictors coexisted (log-rank: p < 0.001). Conclusions. Chronic HCV infection, hypoalbuminemia, and hyponatremia predict progression to advanced liver fibrosis following LT. Patients with these risk factors should be serially monitored using noninvasive fibrosis biomarkers and prioritized for interventions.http://dx.doi.org/10.1155/2017/4381864 |
| spellingShingle | Mamatha Bhat Kathleen C. Rollet-Kurhajec Aparna Bhat Amanda Farag Marc Deschenes Philip Wong Peter Ghali Giada Sebastiani Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients Canadian Journal of Gastroenterology and Hepatology |
| title | Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients |
| title_full | Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients |
| title_fullStr | Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients |
| title_full_unstemmed | Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients |
| title_short | Incidence and Predictors of Advanced Liver Fibrosis by a Validated Serum Biomarker in Liver Transplant Recipients |
| title_sort | incidence and predictors of advanced liver fibrosis by a validated serum biomarker in liver transplant recipients |
| url | http://dx.doi.org/10.1155/2017/4381864 |
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