Common Contracts

Agreement in Pathologic Interpretation of Liver Biopsy Specimens in Posttransplant Hepatitis C Infection

February 4th, 1999

• Filed
  February 4th, 1999

● Hepatitis C virus–related disease is rapidly becoming the most common indication for orthotopic liver transplant (OLT) in the United States. Although post-OLT hepatitis C viremia is universal, 40% to 60% of patients develop re- current chronic hepatitis C. Distinguishing recurrent chronic hepatitis C infection from acute rejection may be difficult because of overlapping histopathologic features. To improve our diagnostic accuracy we undertook a study to determine interobserver and intraobserver agreement between pathologists examining post-OLT liver biopsy specimens in patients from our transplant database. Clini- cal data and microscopic sections from 26 patients with hepatitis C virus–related OLT were reviewed. Biopsy spec- imens were obtained because of abnormal liver enzymes (21/26) or routine post-OLT follow-up (5/26), representing both early (18 ± 11 days) and late (252 ± 206 days) post- OLT periods. Unidentified sections were examined by an experienced pathologist in a randoml