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Histologic Predictors of Fibrosis Progression in Liver Allografts in Patients With Hepatitis C Virus Infection  Zina Meriden, Kimberly A. Forde, Theresa.

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Presentation on theme: "Histologic Predictors of Fibrosis Progression in Liver Allografts in Patients With Hepatitis C Virus Infection  Zina Meriden, Kimberly A. Forde, Theresa."— Presentation transcript:

1 Histologic Predictors of Fibrosis Progression in Liver Allografts in Patients With Hepatitis C Virus Infection  Zina Meriden, Kimberly A. Forde, Theresa L. Pasha, Jia–Ji Hui, K. Rajender Reddy, Emma E. Furth, Rebecca G. Wells  Clinical Gastroenterology and Hepatology  Volume 8, Issue 3, Pages e8 (March 2010) DOI: /j.cgh Copyright © 2010 AGA Institute Terms and Conditions

2 Figure 1 Early biopsies predict the rate of fibrosis. (A) Kaplan–Meier estimates of the development of cirrhosis (METAVIR stage F4) in HCV-infected patients after transplant. The number of cases represented within each cohort is 440, 52, and 61 for the entire cohort, rapid fibrosers, and slow fibrosers, respectively. (B) Kaplan–Meier estimates of the development of fibrosis (METAVIR stages F1–4) in F0 transplant livers of HCV-infected patients. Patients with baseline fibrosis on time zero biopsy were excluded. The number of cases represented within each cohort is 421, 52, and 61 for the entire cohort, rapid fibrosers, and slow fibrosers. (C) Kaplan–Meier estimates of cirrhosis progression according to transplant year in all patients undergoing liver transplantation secondary to HCV. The number of transplant cases represented is 141 for the entire cohort transplanted between 1999 and 2002, and 299 for the entire cohort transplanted between 2003 and The log-rank P value of reflects the comparison in cirrhosis progression among groups from 1999 to 2002 and 2003 to The total cohort includes rapid, slow, and intermediate fibrosers. The number at risk for each year is shown below the graph. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

3 Figure 2 ROC analysis of (A) CK19 expression and (B) Hsp47 expression in stage F0 biopsies of rapid fibrosers versus slow fibrosers. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

4 Figure 3 CK19 and vimentin immunostaining are increased in rapid fibrosers compared with slow fibrosers. Representative F0 biopsies (200×) from (A and C) a slow fibroser and (B and D) a rapid fibroser, immunostained for (A and B) CK19 and (C and D) vimentin expression. CK19 staining was scored as (A) 0 through (B) 3; vimentin was scored as (C) 0 or (D) 1. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

5 Supplementary Figure 1 Early biopsies predict the rate of fibrosis progression in patients transplanted between 2003 and (A) Kaplan–Meier estimates of the development of cirrhosis (METAVIR stage F4) in hepatitis C–infected patients after liver transplant. The number of transplant cases represented within each cohort is 299, 36, and 29 for the entire cohort, rapid fibrosers, and slow fibrosers, respectively. (B) Kaplan–Meier estimates of the development of fibrosis (METAVIR stages F1–F4) in F0 transplant livers of hepatitis C–infected patients. Patients with baseline fibrosis on time zero biopsy were excluded from this analysis. The number of transplant cases represented within each cohort is 281, 36, and 29 for the entire cohort, rapid fibrosers, and slow fibrosers, respectively. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

6 Supplementary Figure 2 Receiver-operating characteristics analysis of (A) CK19 expression and (B) Hsp47 expression in stage F1 biopsies of rapid fibrosers versus slow fibrosers transplanted over the whole study period (1999 to 2007). Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

7 Supplementary Figure 3 Receiver-operating characteristics analysis of (A) CK19 expression and (B) Hsp47 expression in stage F0 biopsies of rapid fibrosers versus slow fibrosers transplanted between 2003 and 2007. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions

8 Supplementary Figure 4 Receiver-operating characteristics analysis of (A) CK19 expression and (B) Hsp47 expression in stage F1 biopsies of rapid fibrosers versus slow fibrosers transplanted between 2003 and 2007. Clinical Gastroenterology and Hepatology 2010 8, e8DOI: ( /j.cgh ) Copyright © 2010 AGA Institute Terms and Conditions


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