A new study from the University of North Carolina at Chapel Hill School of Medicine may have found a way to identify those patients at greatest risk of develop advanced cirrhosis, thereby allowing doctors to decide who should receive treatment that could save the transplanted organ. The research found a laboratory test that shows activation of a certain type of liver cell – hepatic stellate cells – to be useful in determining high risk for developing cirrhosis.
“Right now, there are no reliable tests for identifying the group that’s at high risk,” said lead author Dr. Mark W. Russo, assistant professor of medicine in the Division of Gastroenterology and Hepatology at UNC. Russo and collaborators and the University of Florida focused on hepatic stellate cells (HSCs), which normally store vitamin A in the liver. But they produce collagen and other proteins that can lead to fibrosis, or scarring, in patients infected with hepatitis C virus.
The research team hypothesised that a known valid biomarker of HSC activation – alpha smooth muscle actin (alpha-SMA) – could predict which patients would later develop fibrosis.
The study involved 46 patients with hepatitis C virus who received liver transplants between 1997 and 2001. The patients were divided into two groups: those who developed advanced fibrosis within two years of liver transplant and those who developed mild or no fibrosis in the same period.
Liver tissue samples from four months, one year and two years post-transplant were scored in the laboratory for alpha-SMA. The results showed HSC activation to be significantly higher in the four-month biopsies for those who developed advanced fibrosis within two years.
MEDICA.de; Source: University of North Carolina at Chapel Hill School of Medicine