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Unique clinical conditions associated with different acinar regions of fibrosis in long-term surviving pediatric liver grafts.
- Source :
-
Pediatric transplantation [Pediatr Transplant] 2017 Nov; Vol. 21 (7). Date of Electronic Publication: 2017 Jun 18. - Publication Year :
- 2017
-
Abstract
- In the majority of long-term survivors after PLTx, graft fibrosis has been identified. Recently, subtypes of graft fibrosis have been described based on their predominant acinar localization. We aimed to evaluate whether the development of portal, perisinusoidal, and centrilobular distribution of graft fibrosis is related to patient or transplantation-related parameters. We reviewed the histological features in protocol liver biopsies taken at 1 and 5 years after PLTx of 47 children on a tacrolimus-based immunosuppressive regimen. Fibrosis was assessed according to the LAFSc. The prevalence of portal fibrosis increased from 31% to 62%, sinusoidal from 68% to 79%, and centrilobular from 76% to 85%. The presence of portal fibrosis was associated with total bilirubin and γGT levels (each P<.02) and tended to be associated with biliary complications (P=.06). Sinusoidal fibrosis was associated with prior rejection episodes (P<.02) and centrilobular fibrosis with the presence of HLA mismatches (P=.02). In conclusion, using the LAFSc, we found a high incidence of progressive fibrosis in the 1-year and 5-year protocol biopsies after PLTx. Progression of fibrosis was observed in all acinar compartments, and each of the three locations is associated with different clinical conditions.<br /> (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adolescent
Biopsy
Child
Child, Preschool
Disease Progression
Female
Follow-Up Studies
Graft Rejection diagnosis
Graft Rejection pathology
Graft Rejection prevention & control
Humans
Immunosuppressive Agents therapeutic use
Incidence
Infant
Infant, Newborn
Liver pathology
Liver Cirrhosis diagnosis
Liver Cirrhosis epidemiology
Liver Cirrhosis pathology
Male
Postoperative Complications diagnosis
Postoperative Complications epidemiology
Postoperative Complications pathology
Prevalence
Retrospective Studies
Risk Factors
Tacrolimus therapeutic use
Liver Cirrhosis etiology
Liver Transplantation
Postoperative Complications etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3046
- Volume :
- 21
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pediatric transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 28627016
- Full Text :
- https://doi.org/10.1111/petr.12988