Prospective validation of a noninvasive index for predicting liver fibrosis in hepatitis C virus-infected liver transplant recipients

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Salvador BenllochM Berenguer

Abstract

We previously developed a mathematical model, the Hospital Universitario La Fe (HULF) index, as an alternative to protocol liver biopsy (PLB) to estimate significant fibrosis (SF) in patients who underwent liver transplantation (LT) for liver damage caused by chronic HCV infection. In the present study, we sought to validate this noninvasive index. The commonly derived clinical and laboratory data for calculating the HULF index were prospectively collected over 2.7 years from patients undergoing LT and PLB. The sensitivity, specificity, positive and negative predictive values, and diagnostic capacity were evaluated with receiver operating characteristic curve analysis. Biopsy was performed 93 times in 86 LT patients. The prevalence of SF (F3-F4 on the Knodell scoring system) was 32%. The intraobserver and interobserver concordance was high (kappa = 0.94 and kappa = 0.75, respectively) in identifying SF in PLB. For low scores, the HULF index discarded an SF diagnosis with a sensitivity of 90% and a negative predictive value of 89%. The area under the receiver operating characteristic curve was 0.68. The precision of the HULF index did not improve with the incorporation of donor age and body mass index into the multivariate analy...Continue Reading

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Citations

Mar 27, 2012·Current Hepatitis Reports·A Sidney BarrittPaul H Hayashi
Aug 18, 2012·International Journal of Hepatology·Nobuhisa Akamatsu, Yasuhiko Sugawara
Aug 14, 2010·Transplant International : Official Journal of the European Society for Organ Transplantation·Evangelos CholongitasAndrew K Burroughs
Jul 29, 2010·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Fabio PiscagliaAlice Gianstefani
Apr 27, 2011·Clinical Transplantation·Timothy J S CrossPhillip M Harrison
Dec 25, 2012·Fibrogenesis & Tissue Repair·Ricardo GehrauDaniel Maluf
Aug 4, 2010·Expert Review of Gastroenterology & Hepatology·Daniel G MalufValeria Mas
Jan 10, 2012·Liver International : Official Journal of the International Association for the Study of the Liver·Marina BerenguerJose Ignacio Herrero
Dec 25, 2012·Journal of Hepatology·Marina Berenguer, Detlef Schuppan

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