Fibrosis distribution in explanted cirrhotic livers.
OBJECTIVE
Little information is available regarding the distribution of fibrosis within cirrhotic livers. We measured collagen in cirrhotic explants to determine if fibrosis differs (i) between left (L) and right (R) lobes, and (ii) between different aetiologies.


RESULTS
Ten cases each of common aetiologies of cirrhosis were studied: alcoholic liver disease (ALD), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), hepatitis C virus (HCV) and hepatitis B virus (HBV). A total of 120 tissue blocks (one block each from L and R lobes) were studied. Collagen was measured as collagen proportionate area (CPA), i.e. the proportion of the tissue sections stained by picro-Sirius red. L and R lobes contained similar amounts of fibrosis (r = 0.788; P < 0.0001) with good agreement between L and R lobes (Bland-Altman analysis, R lobe bias = 1.35%). Median CPA across all aetiologies (R plus L lobes) was 21.5%, (L = 8-40%, R = 10-47%). There was more fibrosis in ALD (30%, 15-47%) than PBC (23.5%, 16-34%) and PSC (22.5%, 8-33%), which in turn showed more than AIH (18.5%, 10-40%), HCV (17%, 13-31%) and HBV (16.5%, 8-30%).


CONCLUSIONS
At the time of transplantation cirrhotic livers have different ranges of collagen proportionate area, according to aetiology. R lobe fibrosis corresponds with L lobe fibrosis. The range of fibrosis within each aetiological group could be useful for prognostic subclassification.
The Department of Cellular Pathology, UCL Medical School, Royal Free Campus, London, UK.
Andrew
A
Hall
Giacomo
G
Germani
Graziella
G
Isgrò
Andrew K
AK
Burroughs
Amar P
AP
Dhillon
D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000473:pathology; D015331:Cohort Studies; D003094:Collagen / Q000378:metabolism; D015897:Comorbidity; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000473:pathology; D006526:Hepatitis C / Q000150:complications / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000473:pathology; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged
D003094:Collagen