George M, Paci P, Taner T. Significance of progressive liver fibrosis in pediatric liver transplants: A review of current evidence. World J Gastroenterol 2020; 26(17): 1987-1992 [PMID: 32536769 DOI: 10.3748/wjg.v26.i17.1987]
Corresponding Author of This Article
Timucin Taner, FACS, MD, PhD, Associate Professor, Surgeon, Departments of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States. taner.timucin@mayo.edu
Research Domain of This Article
Transplantation
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 7, 2020; 26(17): 1987-1992 Published online May 7, 2020. doi: 10.3748/wjg.v26.i17.1987
Significance of progressive liver fibrosis in pediatric liver transplants: A review of current evidence
Mathew George, Philippe Paci, Timucin Taner
Mathew George, Philippe Paci, Timucin Taner, Departments of Surgery, Mayo Clinic, Rochester, MN 55905, United States
Timucin Taner, Departments of Immunology, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: George M, Paci P and Taner T conceived and outlined the review; George M and Paci P performed literature review and wrote the manuscript; Taner T made critical revisions and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Timucin Taner, FACS, MD, PhD, Associate Professor, Surgeon, Departments of Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States. taner.timucin@mayo.edu
Received: December 31, 2019 Peer-review started: December 31, 2019 First decision: February 19, 2020 Revised: March 31, 2020 Accepted: April 21, 2020 Article in press: April 21, 2020 Published online: May 7, 2020
Abstract
This article reviews the current evidence and knowledge of progressive liver fibrosis after pediatric liver transplantation. This often-silent histologic finding is common in long-term survivors and may lead to allograft dysfunction in advanced stages. Surveillance through protocolized liver allograft biopsy remains the gold standard for diagnosis, and recent evidence suggests that chronic inflammation precedes fibrosis.
Core tip: Progressive liver allograft fibrosis is a common finding after liver transplantation in children and may lead to allograft failure in the long-term. Recent data from centers performing sequential protocol biopsies after pediatric liver transplantation demonstrate that chronic inflammation precedes fibrosis. In this review, we provide an update on pathogenesis, diagnosis and management of progressive liver fibrosis in pediatric liver transplant recipients.
