Collagen proportionate area (CPA, %) is used to quantify liver fibrosis. Here we assessed CPA performance to subclassify cirrhosis. CPA was measured in explanted livers from consecutively transplanted patients for hepatitis C virus-related cirrhosis. MELD, Child-Pugh score and decompensating events (ascites, variceal bleeding, non-obstructive jaundice and encephalopathy) were recorded at the time of liver transplant. Of the 154 patients, 24%, 12%, 35%, 24% and 5% had 0, 1, 2, 3 and 4 previous decompensating events. Patients with decompensation had significantly higher CPA than those without (25.1±8.4 vs. 15.8±5.5, P<0.001). Decompensation was independently associated with CPA, bilirubin and albumin or with CPA and MELD score. CPA did not differ between patients with 1, 2, 3 or 4 decompensating events (22.2±6.3 vs. 26.6±8.9 vs. 24.5±7.7 vs. 24.4±10.9, P=0.242). Overall, CPA correlates with the clinical severity of cirrhosis until the advent of decompensation but not with subsequent decompensating events.
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