Copyright
©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2014; 20(21): 6638-6650
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6638
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6638
Protocol liver biopsy is the only examination that can detect mid-term graft fibrosis after pediatric liver transplantation
Yukihiro Sanada, Taizen Urahashi, Yoshiyuki Ihara, Taiichi Wakiya, Noriki Okada, Naoya Yamada, Yuta Hirata, Koichi Mizuta, Department of Transplant Surgery, Jichi Medical University, Tochigi 329-0498, Japan
Koshi Matsumoto, Department of Clinical Pathology, Ebina General Hospital, Kanagawa Prefecture 243-0433, Japan
Author contributions: Sanada Y participated in making the research design, analyzing data, and writing the article; Urahashi T, Ihara Y, Wakiya T, Okada N, Yamada N and Hirata Y participated in the data collection, data analysis and writing of the discussion; Matsumoto K and Mizuta K participated in the research design, writing of the discussion and review of the article.
Correspondence to: Yukihiro Sanada, MD, PhD, Department of Transplant Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi 329-0498, Japan. yuki371@jichi.ac.jp
Telephone: +81-285-587069 Fax: +81-285-587069
Received: July 24, 2013
Revised: November 12, 2013
Accepted: November 28, 2013
Published online: June 7, 2014
Revised: November 12, 2013
Accepted: November 28, 2013
Published online: June 7, 2014
Core Tip
Core tip: Few studies have investigated the impact of the timing and effectiveness of post-transplant protocol liver biopsy (PLB). We assessed the histopathological findings of these biopsies using the Metavir scoring system, and our results clarified the timing and effectiveness of PLB. PLB at two years after pediatric liver transplantation is an unnecessary examination, because the serum alanine amino transaminase (ALT) level reflects portal inflammation. In addition, immunosuppressive therapy should be modulated to maintain the ALT concentration at a level less than 20 IU/L. PLB at five years is an excellent examination for the detection of early reversible graft fibrosis because no serum markers reflect this finding.