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Rushakoff JA, Kransdorf EP, Patel JK, et al. Heterogeneity of liver fibrosis in patients with congestive hepatopathy: A biopsy and explant comparison series. Ann Diagn Pathol. 2021;56:151876doi: 10.1016/j.anndiagpath.2021.151876.
Rushakoff, J. A., Kransdorf, E. P., Patel, J. K., Kobashigawa, J. A., Sundaram, V., & Guindi, M. (2022). Heterogeneity of liver fibrosis in patients with congestive hepatopathy: A biopsy and explant comparison series. Annals of diagnostic pathology, 56151876. https://doi.org/10.1016/j.anndiagpath.2021.151876
Rushakoff, Joshua A, et al. "Heterogeneity of liver fibrosis in patients with congestive hepatopathy: A biopsy and explant comparison series." Annals of diagnostic pathology vol. 56 (2022): 151876. doi: https://doi.org/10.1016/j.anndiagpath.2021.151876
Rushakoff JA, Kransdorf EP, Patel JK, Kobashigawa JA, Sundaram V, Guindi M. Heterogeneity of liver fibrosis in patients with congestive hepatopathy: A biopsy and explant comparison series. Ann Diagn Pathol. 2022 Feb;56:151876. doi: 10.1016/j.anndiagpath.2021.151876. Epub 2021 Dec 13. PMID: 34920382.
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Ann Diagn Pathol. 2022 Feb;56:151876. doi: 10.1016/j.anndiagpath.2021.151876. Epub 2021 Dec 13.

Heterogeneity of liver fibrosis in patients with congestive hepatopathy: A biopsy and explant comparison series.

Annals of diagnostic pathology

Joshua A Rushakoff, Evan P Kransdorf, Jignesh K Patel, Jon A Kobashigawa, Vinay Sundaram, Maha Guindi

Affiliations

  1. Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
  2. Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America. Electronic address: [email protected].
  3. Division of Gastroenterology and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.
  4. Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America.

PMID: 34920382 DOI: 10.1016/j.anndiagpath.2021.151876

Abstract

PURPOSE: Patients with end-stage heart failure and concomitant irreversible liver injury may be candidates for combined heart liver transplant (CHLT). Determining appropriate candidates for CHLT is essential given organ scarcity. Transjugular liver biopsy (TJLB) is used to evaluate the severity of parenchymal liver injury in transplant candidates. In patients with congestive hepatopathy (CH), the fibrosis pattern may be heterogenous.

METHODS: We reviewed all CHLT cases between 2007 and 2017, as well as lone-heart transplant cases with post-mortem autopsy. Pre-transplant TJLB was compared to explant to assess the performance of biopsy fibrosis staging.

RESULTS: 12 patients were included. Median age at time of transplant was 58 and the cohort was predominantly male (75%). Seven (64%) TJLB were predominantly stage 4 fibrosis and 4 (36%) were stage 1. Advanced fibrosis was the dominant pattern in 7 (70%) explants and 5 (50%) explants had heterogenous fibrosis. In 50% of CH cases, there was discordance between the TJLB and explant. In the autopsy cases, the TJLB and autopsy findings differed.

CONCLUSIONS: In this series of matched TJLB and explanted livers, we found variable performance of TJLB in predicting the predominant fibrosis stage present in the liver.

Copyright © 2021 Elsevier Inc. All rights reserved.

Keywords: Combined heart liver transplantation; Congestive hepatopathy; Explant pathology; Transjugular liver biopsy

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