Volume 138, Issue 1, Pages 147-158.e1 (January 2010) Serum Fibrosis Markers Identify Patients With Mild and Progressive Hepatitis C Recurrence After Liver Transplantation  José A. Carrión, Guillermo Fernández–Varo, Miquel Bruguera, Juan–Carlos García–Pagán, Juan–Carlos García–Valdecasas, Sofía Pérez–Del–Pulgar, Xavier Forns, Wladimiro Jiménez, Miquel Navasa  Gastroenterology  Volume 138, Issue 1, Pages 147-158.e1 (January 2010) DOI: 10.1053/j.gastro.2009.09.047 Copyright © 2010 AGA Institute Terms and Conditions

Figure 1 Serum concentrations of HA (A), PIIINP (B), TIMP-1 (C), and 3-M-ALG (D) at 3, 6, and 12 months after LT. Serum concentrations of HA, PIIINP, and TIMP-1 and the 3-M-ALG did not progress in HCV-negative and HCV-infected patients with mild recurrence, whereas PIIINP (P = .001), TIMP-1 (P = .002), and 3-M-ALG (P = .001) increased in patients with progressive recurrence. Boxplots show the interquartile range (IQR, 25th percentile to 75th percentile) and outliers. Differences between related samples were analyzed with Friedman test. Gastroenterology 2010 138, 147-158.e1DOI: (10.1053/j.gastro.2009.09.047) Copyright © 2010 AGA Institute Terms and Conditions

Figure 2 Values of 3-M-ALG at 6 (A) and 12 (B) months after LT in HCV-negative patients and patients with hepatitis C recurrence according to fibrosis stage and HVPG values. Median values of 3-M-ALG are represented with a horizontal line. The dotted line depicts the best cutoff of 3-M-ALG to identify patients without risk of developing portal hypertension (HVPG ≥ 6 mm Hg) at 6 months and patients with normal portal pressure at 12 months. Differences between categorized groups were analyzed with Mann-Whitney test. Gastroenterology 2010 138, 147-158.e1DOI: (10.1053/j.gastro.2009.09.047) Copyright © 2010 AGA Institute Terms and Conditions

Figure 3 Diagnostic accuracy of AST/ALT, APRI, Benlloch score, and 3-M-ALG at 6 (A) and 12 (B) months after LT to predict the risk of developing significant fibrosis and portal hypertension. (A) Diagnostic accuracy (AUROC) of 3-M-ALG at 6 months after LT was higher (P < .05) than APRI and the Benlloch score to identify patients at risk of developing significant fibrosis and higher than the 3 indexes to identify patients at risk of developing portal hypertension. (B) The AUROC of 3-M-ALG at 12 months after LT was higher than the 3 indexes to identify patients with significant fibrosis and higher than APRI and the Benlloch score to identify patients with portal hypertension (Table 3). Gastroenterology 2010 138, 147-158.e1DOI: (10.1053/j.gastro.2009.09.047) Copyright © 2010 AGA Institute Terms and Conditions

Figure 4 Cumulative incidence of clinical decompensation (A) and survival (B) in patients with a different cutoff of 3-M-ALG at 12 months after LT. Patients with 3-M-ALG ≥ 2 are shown with a continuous line. Patients with 3-M-ALG < 2 are depicted with a dotted line. The probability of developing clinical decompensation was significantly higher in patients with 3-M-ALG ≥ 2 (events = 20) than those with 3-M-ALG < 2 (events = 14) (P < .0001, log-rank test). The cumulative survival was significantly higher in patients with 3-M-ALG < 2 (events = 11) compared with patients with 3-M-ALG ≥ 2 (events = 6) (P < .001, log-rank test). Gastroenterology 2010 138, 147-158.e1DOI: (10.1053/j.gastro.2009.09.047) Copyright © 2010 AGA Institute Terms and Conditions