Conflicts of Interest None.
Liver histology as predictor of outcome in patients with acute liver failure
Article first published online: 5 APR 2012
© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation
Special Issue: Special Focus - Antibody-Mediated Rejection
Volume 25, Issue 6, pages 658–662, June 2012
How to Cite
Singhal, A., Vadlamudi, S., Stokes, K., Cassidy, F. P., Corn, A., Shrago, S. S., Wright, H. I. and Kohli, V. (2012), Liver histology as predictor of outcome in patients with acute liver failure. Transplant International, 25: 658–662. doi: 10.1111/j.1432-2277.2012.01470.x
This data was awarded with ‘Young Investigator Award’ at the 17th Annual International Congress of International Liver Transplantation Society, June 22–25, 2011, Valencia, Spain.
- Issue published online: 15 MAY 2012
- Article first published online: 5 APR 2012
- Received: 21 September 2011 Revision requested: 16 October 2011 Accepted: 2 March 2012 Published online: 5 April 2012
Acute liver failure (ALF) is a clinical syndrome associated with significant morbidity and mortality with a highly unpredictable outcome. We retrospectively analyzed 71 ALF patients (53 males; mean age = 27.5 ± 15.6 years) that underwent transjugular liver biopsy (TJLB) at our institution. The aims of this study are (i) to report our experience with TJLB in these patients, and (ii) to examine the role of liver histology in predicting their outcome. We also compared the histopathological findings between TJLB and explanted liver specimens in 31 patients who underwent liver transplantation (LT). Biopsy specimens were satisfactory for histopathological analyses in 69 (97.1%) patients, confirmed the clinical diagnosis in 56 (81.2%) patients, and altered the diagnosis in 13 (18.8%) patients. Minor complications were encountered in four (5.6%) patients. Percentage of hepatocyte necrosis was the only histological parameter that has significant discriminatory prognostic value, with no survivors having >75% necrosis without LT. In conclusions, TJLB is a safe technique for obtaining liver tissue in both adult and pediatric patients with ALF. Histological characteristics, mainly etiological diagnosis and degree of hepatocyte necrosis may assist in clinical decision-making for need of LT in these patients.