Liver collagen proportionate area predicts decompensation in patients with recurrent hepatitis C virus cirrhosis after liver transplantation

Vincenza Calvaruso, Amar Paul Dhillon, Emanuel Tsochatzis, Pinelopi Manousou, Federica Grillo, Giacomo Germani, David Patch, James O'Beirne, Andrew Kenneth Burroughs

Research output: Contribution to journalArticle


Background and Aims: Current histological scoring systems do not subclassify cirrhosis. Computer-assisted digital image analysis (DIA) of Sirius Red-stained sections measures fibrosis morphologically producing a fibrosis ratio (collagen proportionate area [CPA]). CPA could have prognostic value within a disease stage, such as cirrhosis. The aim of the present study was to evaluate CPA in patients with recurrent hepatitis C virus (HCV) allograft cirrhosis and assess its relationship with hepatic venous pressure gradient (HVPG). Methods: In 121 consecutively-transplanted HCV patients with HVPG, measured contemporaneously with transjugular liver biopsies, 65 had Ishak stage 5 or 6 disease (43 with HVPG measurement). Biopsies were stained with Sirius Red for DIA, and the collagen content was expressed as a CPA. In three cases, a tissue for Sirius Red staining was not obtained, and the patients were excluded. Results: Sixty-two patients were analyzed. The median HVPG was 8mmHg (interquartile range [IQR]: 5-10). Portal hypertension (HVPG ≥6

Original languageEnglish
Pages (from-to)1227-1232
Number of pages6
JournalJournal of Gastroenterology and Hepatology
Issue number7
Publication statusPublished - 2012



  • Cirrhosis
  • Collagen proportionate area
  • Hepatic venous pressure gradient
  • Prognosis

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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