title: The histological quantification of alpha-smooth muscle actin predicts future graft fibrosis in pediatric liver transplant recipients.
abstract: Activated hepatic stellate cells express cytoplasmic ASMA prior to secreting collagen and consequent liver fibrosis. We hypothesized that quantifying ASMA could predict severity of future fibrosis after LT. For this, 32 pairs of protocol biopsies, that is, "baseline" and "follow-up" biopsies taken at 1- to 2-year intervals from 18 stable pediatric LT recipients, transplanted between 2006 and 2012 were selected. Morphometric quantification of "ASMA-positive area percentage" was performed on the baseline biopsy. Histological and fibrosis assessment using Metavir and LAFSc was performed on all biopsies. The difference of fibrosis severity between the "baseline" and "follow-up" was termed "prospective change in fibrosis." Significant association was seen between extent of ASMA positivity on baseline biopsy and "prospective change in fibrosis" using Metavir (P=.02), cumulative LAFSc (P=.02), and portal LAFSc (P=.01) values. ASMA-positive area percentage >1.05 predicted increased fibrosis on next biopsy with 90.0% specificity. Additionally, an association was observed between extent of ASMA positivity and concomitant ductular reaction (P=.06), but not with histological inflammation in the portal tract or lobular area. Hence, ASMA quantification can predict the future course of fibrosis.
authors: Service de Gastroentérologie et Hépatologie Pédiatrique, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.|Pediatric Research Unit, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Sharat
authors: S
authors: Varma
authors: Service de Gastroentérologie et Hépatologie Pédiatrique, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.|Pediatric Research Unit, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Xavier
authors: X
authors: Stéphenne
authors: Service de Anatomopathologie, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Mina
authors: M
authors: Komuta
authors: Imaging Platform (2IP), Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Caroline
authors: C
authors: Bouzin
authors: Centre for Applied Molecular Technologies (CTMA), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Jerome
authors: J
authors: Ambroise
authors: Service de Gastroentérologie et Hépatologie Pédiatrique, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.|Pediatric Research Unit, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Françoise
authors: F
authors: Smets
authors: Unités de Chirurgie Pédiatrique, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Raymond
authors: R
authors: Reding
authors: Service de Gastroentérologie et Hépatologie Pédiatrique, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.|Pediatric Research Unit, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium.
authors: Etienne M
authors: EM
authors: Sokal
mesh_terms: D000199:Actins / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000378:metabolism; D005260:Female; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000503:physiopathology; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D009130:Muscle, Smooth / Q000378:metabolism*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D066027:Transplant Recipients
chemical_list: D000199:Actins; D003094:Collagen
keywords: alpha-smooth muscle actin; fibrosis prediction; hepatic fibrosis; hepatic stellate cells; liver biopsy; pediatric liver transplantation