Protocol liver biopsies in long-term management of patients transplanted for hepatitis B-related liver disease

Table 1 Pre-transplant HBV-DNA in the study population and outcome after liver transplantation

Indication	n	HBV DNA		Total recurrence
		Negative	Unknown
Cirrhosis	38	34	4	7
HBV	19	16	3	5
HBV-HDV	12	11	1	2
HBV-HCV	7	7
Fulminant hepatitis	4		4

Subgroups of HBV patients (with HDV/HCV coinfection and fulminant hepatitis) showing pre-transplant HBV-DNA status and disease recurrence.

Table 2 Histological features in anti-HCV negative patients, transplanted for HBV-related liver cirrhosis with no HBV recurrence

	6	1	2	3	4	5	6	7	8
	mo	yr	yr	yr	yr	yr	yr	yr	yr
n	28	26	19	16	12	11	8	8	4
No. of biopsies/total biopsies (%)
Negative	5/26	9/23	4/19	6/14	6/12	3/10	4/8	4/8	1/2
	(19.2%)	(39.1%)	(21.0%)	(42.8%)	(50.0%)	(30.0%)	(50.0%)	(50.0%)	(50.0%)
Minimal, not	19/26	8/23	11/19	6/14	5/12	6/10	2/83/81/2
otherwise specified	(73.0%)	(39.7%)	(57.8%)	(42.8%)	(41.6%)	(60.0%)	(25.0%)	(37.5%)	(50.0%)
hanges
Mild chronic hepatitis	2/26	6/23	4/19	2/14	-	-	1/8
	(7.6%)	(26.0%)	(21.0%)	(14.2%)	-	-	(12.5%)
Moderate chronic	-	-	-	-	1/12	1/10	1/8	1/8
hepatitis					(8.3%)	(10.0%)	(12.5%)	(12.5%)
Severe chronic	-	-	-	-	-	-	-	-	-
hepatitis
Cirrhosis	-	-	-	-	-	-	-	-

Histological features in 122 liver biopsies performed in 28 anti-HCV negative patients transplanted for HBV-related liver disease with no HBV recurrence. The number of patients considered declined year by year and the total number of liver biopsies performed each year is less than the number of patients per year.

Table 3 Staging and grading of liver damage in patients transplanted for HBV- and HCV-related liver cirrhosis

Pts	Stage	Grade	Months after transplantation
1	1	4	36
2	2	4	48
3	1	4	24
4	2	10	12
5	0	2	36
6	2	5	12
7	1	2	12

The worst grades and stages were in the 7 HBV/HCV coinfected patients. Staging and grading are based on Ishak’s classification [24].