title: Revealing the cause of cryptogenic cirrhosis by posttransplant liver biopsy.
abstract: BACKGROUND
  Because of the tendency for preexisting diseases to recur following liver transplantation, studying the course of patients who were transplanted for their cryptogenic cirrhosis may reveal features of the original cause. We examined the clinicopathological posttransplant progression of patients transplanted due to cryptogenic cirrhosis with emphasis on the detection of posttransplant steatosis and steatohepatitis.
  
  
  METHODS
  The data on all patients transplanted for cryptogenic cirrhosis and their routine 1-year posttransplant liver biopsies were compared to a control group of a randomized sample of patients transplanted for other indications matched for length of follow-up. The posttransplant histological diagnosis was based on the latest available biopsy.
  
  
  RESULTS
  Among 1710 patients, 39 present with cryptogenic etiology survived at least 1 year after transplantation. The control group consisted of 78 patients. The mean ages of the two groups were 50.7 and 49.3 years and the mean follow-up periods 6.2 and 5.7 years, both of which were similar. There was a significantly greater prevalence of posttransplant steatosis and steatohepatitis among the cryptogenic group (37.5 vs 16.7%, P = .048). The difference in patients with at least moderate steatosis was more pronounced (18.8 vs 3.3%, P = .035). Half of these cases progressed to fibrosis and cirrhosis after 48 months.
  
  
  CONCLUSIONS
  This study found a greater incidence of allograft steatosis and steatohepatitis among patients transplanted for cryptogenic cirrhosis compared with a control group. A significant proportion of these patients developed a picture resembling nonalcoholic steatohepatitis, which progressed to fibrosis and cirrhosis.
authors.affiliation: Singapore Liver Transplant Program, National University Hospital, Singapore. dedess@nuh.com.sg
authors.forename: D S
authors.initials: DS
authors.lastname: Sutedja
authors.forename: P J
authors.initials: PJ
authors.lastname: Gow
authors.forename: S G
authors.initials: SG
authors.lastname: Hubscher
authors.forename: E
authors.initials: E
authors.lastname: Elias
mesh_terms: D000328:Adult; D001706:Biopsy; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors