0000000000328493

AUTHOR

Amar P. Dhillon

showing 6 related works from this author

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

2012

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 (4…

medicine.medical_specialtyCirrhosisHepatologybusiness.industryPortal venous pressuremedicine.medical_treatmentGastroenterologyHepatitis CLiver transplantationmedicine.diseaseGastroenterologychemistry.chemical_compoundchemistryInterquartile rangeInternal medicinecardiovascular systemmedicinePortal hypertensionheterocyclic compoundsDecompensationbusinessSirius RedJournal of Gastroenterology and Hepatology
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Computer-assisted image analysis of liver collagen: relationship to Ishak scoring and hepatic venous pressure gradient.

2009

Histopathological scoring of disease stage uses descriptive categories without measuring the amount of fibrosis. Collagen, the major component of fibrous tissue, can be quantified by computer-assisted digital image analysis (DIA) using histological sections. We determined relationships between DIA, Ishak stage, and hepatic venous pressure gradient (HVPG) reflecting severity of fibrosis. One hundred fifteen patients with hepatitis C virus (HCV) who had undergone transplantation had 250 consecutive transjugular liver biopsies combined with HVPG (median length, 22 mm; median total portal tracts, 12), evaluated using the Ishak system and stained with Sirus red for DIA. Liver collagen was expres…

AdultLiver CirrhosisMalemedicine.medical_specialtyCirrhosismedicine.medical_treatmentPortal venous pressureImage ProcessingBiopsyLiver transplantationHepatic VeinsGastroenterologyComputer-AssistedInternal medicineBiopsymedicineImage Processing Computer-AssistedHumansProspective StudiesAgedHepatologymedicine.diagnostic_testbusiness.industryHepatologyMiddle Agedmedicine.diseaseHepatitis CConfidence intervalSurgeryLiver TransplantationTransplantationLogistic ModelsLiverAdult; Aged; Biopsy; Collagen; Female; Hepatic Veins; Hepatitis C; Humans; Liver; Liver Cirrhosis; Liver Transplantation; Logistic Models; Male; Middle Aged; Prospective Studies; Venous Pressure; Image Processing Computer-AssistedFemaleCollagenTransient elastographybusinessVenous Pressurecollagen proportionate area HVPG liver fibrosisHepatology (Baltimore, Md.)
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Digital image analysis of liver collagen predicts clinical outcome of recurrent hepatitis C virus 1 year after liver transplantation.

2011

Clinical outcomes of recurrent hepatitis C virus after liver transplantation are difficult to predict. We evaluated collagen proportionate area (CPA), a quantitative histological index, at 1 year with respect to the first episode of clinical decompensation. Patients with biopsies at 1 year after liver transplantation were evaluated by Ishak stage/grade, and biopsy samples stained with Sirius red for digital image analysis were evaluated for CPA. Cox regression was used to evaluate variables associated with first appearance of clinical decompensation. Receiver operating characteristic (ROC) curves were also used. A total of 135 patients with median follow-up of 76 months were evaluated. At 1…

Liver CirrhosisMaleCirrhosisTime FactorsPortal venous pressuremedicine.medical_treatmentBiopsyKaplan-Meier EstimateLiver transplantationmedicine.disease_causeGastroenterologyRecurrenceRisk FactorsLondonChildFirst episodemedicine.diagnostic_testMiddle AgedHepatitis CLiverFemaleCollagenAdultmedicine.medical_specialtyAdolescentHepatitis C virusHepatic VeinsRisk AssessmentSensitivity and SpecificityEnd Stage Liver DiseaseYoung AdultPredictive Value of TestsInternal medicineBiopsyImage Interpretation Computer-AssistedmedicineHumansDecompensationAgedProportional Hazards ModelsRetrospective StudiesTransplantationHepatologybusiness.industrymedicine.diseaseSurgeryLiver TransplantationTransplantationROC CurveSurgerybusinessVenous PressureLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
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Digital image analysis of collagen assessment of progression of fibrosis in recurrent HCV after liver transplantation

2013

BACKGROUND & AIMS: Histological assessment of fibrosis progression is currently performed by staging systems which are not continuous quantitative measurements. We aimed at assessing a quantitative measurement of fibrosis collagen proportionate area (CPA), to evaluate fibrosis progression and compare it to Ishak stage progression. METHODS: We studied a consecutive cohort of 155 patients with recurrent HCV hepatitis after liver transplantation (LT), who had liver biopsies at one year and were subsequently evaluated for progression of fibrosis using CPA and Ishak staging, and correlated with clinical decompensation. The upper quartile of distribution of fibrosis rates (difference in CPA or Is…

AdultLiver CirrhosisMalemedicine.medical_specialtyCirrhosisAdolescentmedicine.medical_treatmentBiopsyLiver transplantationGastroenterologySeverity of Illness IndexCohort StudiesYoung AdultFibrosisRecurrenceRisk FactorsInternal medicineSeverity of illnessBiopsyAzathioprinemedicineImage Processing Computer-AssistedHumansDecompensationAgedHepatitisHepatologymedicine.diagnostic_testliver transplantationbusiness.industryHepatitis CMiddle Agedmedicine.diseaseHepatitis CSurgeryLiverWithholding TreatmentDisease ProgressionRegression AnalysisFemaleCollagenbusinessImmunosuppressive AgentsFollow-Up Studies
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The relationship between transient elastography and histological collagen proportionate area for assessing fibrosis in chronic viral hepatitis

2012

Collagen proportionate area (CPA) has a better correlation with hepatic venous pressure gradient (HVPG) than with Ishak stage. Liver stiffness measurement (LSM) is proposed as non invasive marker of portal hypertension/disease progression. Our aim was to compare LSM and CPA with Ishak staging in chronic viral hepatitis, and HVPG in HCV hepatitis after transplantation. One hundred and sixty-nine consecutive patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections pre/post liver transplantation (LT), had a liver biopsy combined with LSM (transient elastography), CPA (biopsies stained with Sirius Red and evaluated by digital image analysis and expressed as CPA) and H…

AdultLiver CirrhosisMalemedicine.medical_specialtyCirrhosisHepatitis C virusmedicine.medical_treatmentBiopsyLiver transplantationmedicine.disease_causeGastroenterologyYoung AdultHepatitis B ChronicInternal medicinemedicineImage Processing Computer-AssistedHumansheterocyclic compoundsAgedtransient elastography histological collagen proportionate area fibrosis chronic viral hepatitis.medicine.diagnostic_testbusiness.industryfibrosisGastroenterologyHepatologyHepatitis C ChronicMiddle Agedmedicine.diseasetransient elastographychronic viral hepatitisLiver TransplantationTransplantationhistological collagen proportionate areaLiver biopsyMultivariate Analysiscardiovascular systemDisease ProgressionElasticity Imaging TechniquesRegression AnalysisFemaleCollagenTransient elastographyViral hepatitisbusiness
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Histological subclassification of cirrhosis

2010

medicine.medical_specialtyCirrhosisHepatologybusiness.industrymedicine.medical_treatmentcirrhosisMEDLINEHepatitis CLiver transplantationmedicine.diseaseGastroenterologyText miningFibrosisInternal medicineMedicinebusiness
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