The 76 liver samples as a group were reviewed independently and blindly by two of the study designers (C.S., C.V.) separated by a 2-month period. Every LB was scored twice and the final results were analyzed for intra/ interobserver agreement. In addition, for testing of the reproducibility level of LAFSc, the same H&E and Masson's trichrome-stained samples were also evaluated by another experienced pathologist (J.C.F.) from the Hospital Vall d�� Hebron, Barcelona, (Spain), and the level of agreement between experienced pathologists (C.S.�CJ.C.F.) was correlated. TE and APRI results were only obtained in all cases at the time of the LB protocol at 7 years; these data were not available at 6 months. The technique for measuring TE has been described in previous publications (33). In brief, an ultrasound Cabozantinib
transducer probe is mounted on the axis of a vibrator and low-frequency vibrations are transmitted by the transducer. The device (Fibroscan?, Echosens, Paris, France) generates waves when placed on the skin between the ribs at the level of the right face of the liver. The vibrator produces a shot, and a low-amplitude shear wave is propagated through the liver parenchyma. Propagation velocity is directly proportional to liver stiffness. The range of measurements is expressed in kilopascals (kPa) and varies from 2.5 Z-VAD-FMK order
to 74 kPa. Serum AST activity and platelet count, both of which were obtained from routine biochemistry immediately before the LB procedure, were used for APRI calculation. APRI was calculated according to the formula proposed by Wai et al. (34) as follows: The see more
statistical software used was SPSS version 18.0 (Chicago IL.) Results were expressed as percentage, median, mean and SD, and statistical significance was assumed for p < 0.05. The nonparametric Spearman correlation (rho) was performed to evaluate the relationships among morphometry, METAVIR, Ishak and LAFSc systems. A perfect rho correlation of +1 or �C1 occur when each of the variables preserves the perfect given order. A �C1 indicates a perfect negative correlation, whereas a +1 indicates a perfect positive correlation. A correlation of zero means there is no relationship between the two variables. Linear and quadratic regressions were fitted to analyze the relationship between the LAFSc system and collagen deposits (PSR%). Consistency of the measurement and intra/inter value agreement was evaluated using intraclass correlation. Details of liver enzymes values, immunosuppression, AR episodes, fibrosis staging using LAFSc system and associated histologic features at 6 months and 7 years are detailed in Table 2. Details of the evolution of patients with elevated liver enzymes (biochemistry, immunosuppression, LAF staging and associated histologic features) are shown in Table 3.