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Hepatology International
January 2017, Volume 11, Issue 1, pp 1–30
Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update
Authors
Authors and affiliations
Gamal Shiha 12 Email author
Alaa Ibrahim 3
Ahmed Helmy 6
Shiv Kumar Sarin 4
Masao Omata 5
Ashish Kumar 7
David Bernstien 8
Hitushi Maruyama 9
Vivek Saraswat 10
Yogesh Chawla 11
Saeed Hamid 12
Zaigham Abbas 13
Pierre Bedossa 14
Puja Sakhuja 15
Mamun Elmahatab 16
Seng Gee Lim 17
Laurentius Lesmana 18
Jose Sollano 19
Ji-Dong Jia 20
Bahaa Abbas 21
Ashraf Omar 22
Barjesh Sharma 23
Diana Payawal 24
Ahmed Abdallah 25
Abdelhamid Serwah 26
Abdelkhalek Hamed 27
Aly Elsayed 28
Amany AbdelMaqsod 29
Tarek Hassanein 30
Ahmed Ihab 31
Hamsik GHaziuan 32
Nizar Zein 33
Manoj Kumar 4
1.Internal Medicine Department, El-Mansoura Faculty of Medicine Mansoura University Mansoura Egypt
2.Egyptian Liver Research Institute And Hospital (ELRIAH)Mansoura Egypt
3.Department of Internal medicineUniversity of Benha Benha Egypt
4.Department of HepatologyInstitute of Liver and Biliary Sciences (ILBS)New Delhi India
5.Department of GastroenterologyUniversity of Tokyo Tokyo Japan
6.Department of Tropical Medicine & Gastroenterology, Faculty of Medicine Assiut UniversityAssiut Egypt
7.Department of Gastroenterology & Hepatology Ganga Ram Institute for Postgraduate Medical Education & Research of Sir Ganga Ram Hospital New DelhiIndia
8.Division of Hepatology North Shore University Hospital and Long Island Jewish Medical CenterNew York USA
9.Department of Gastroenterology Chiba University Graduate School of Medicine Chiba Japan
10.Department of Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India
11.Post Graduate Institute of Medial Education & Research Chandigarh India
12.Department of MedicineThe Aga Khan University & Hospital Karachi Pakistan
13.Department of Hepatogastroenterology Sindh Institute of Urology and Transplantation Karachi Pakistan
14.Department of Pathology, Physiology and Imaging University Paris Diderot Paris France
15.Govind Ballabh Pant Hospital Maulana Azad Medical College New Delhi India
16.Department of Hepatology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh
17.Department of Medicine, Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
18.Department of Medicine University of Indonesia Depok Indonesia
19.University of Santo Tomas Manila Philippines
20.Liver Research Centre at the Beijing Friendship Hospital Capital University in Beijing Beijing China
21.Department of Internal Medicine Military Medical Academy Cairo Egypt
22.Tropical Medicine Department Cairo Medical School Cairo Egypt
23.Department of Gastroenterology GB Pant Hospital New Delhi India
24.Section of Gastroenterology Cardinal Santos Medical Center San Juan City, Metro Manila Philippines
25.Pediatric Hospital Mansoura University Mansoura Egypt
26.College of MedicineTaif UniversityTaif Kingdom of Saudi Arabia
27.Hepatology and Diabetes Unit Military Medical Academy Cairo Egypt
28.Hepatology & GIT Department AHF Center Abu Dhabi Abu Dhabi United Arab Emirates
29.Internal Medicine Department, Faculty of Medicine Cairo University, Liver Transplant Unit Manial Hospital and Liver ICU French Hospital Cairo University Cairo Egypt
30.Chula Vista Medical Center Chula Vista USA
31.Molecular Pathology Unit & Research Group German University in Cairo Cairo Egypt
32.Department of Hepatology Nork Clinical Hospital of Infectious Diseases Yerevan Armenia
33.Department of Gastroenterology and Hepatology Cleveland Clinic Cleveland USA
Guidelines
First Online:
06 October 2016
DOI: 10.1007/s12072-016-9760-3
Cite this article as:
Shiha, G., Ibrahim, A., Helmy, A. et al. Hepatol Int (2017) 11: 1. doi:10.1007/s12072-016-9760-3
2 Citations 3 Shares 1.5k Downloads
Abstract
Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated. The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on liver fibrosis in 2007, with a mandate to develop consensus guidelines on various aspects of liver fibrosis relevant to disease patterns and clinical practice in the Asia-Pacific region. The first consensus guidelines of the APASL recommendations on hepatic fibrosis were published in 2009. Due to advances in the field, we present herein the APASL 2016 updated version on invasive and non-invasive assessment of hepatic fibrosis. The process for the development of these consensus guidelines involved review of all available published literature by a core group of experts who subsequently proposed consensus statements followed by discussion of the contentious issues and unanimous approval of the consensus statements. The Oxford System of the evidence-based approach was adopted for developing the consensus statements using the level of evidence from one (highest) to five (lowest) and grade of recommendation from A (strongest) to D (weakest). The topics covered in the guidelines include invasive methods (LB and hepatic venous pressure gradient measurements), blood tests, conventional radiological methods, elastography techniques and cost-effectiveness of hepatic fibrosis assessment methods, in addition to fibrosis assessment in special and rare situations.
Keywords
Liver fibrosisInvasive assessment, non-invasive assessmentCirrhosisHepatitis CHepatitis BChronic liver diseaseNon-alcoholic steatohepatitisGraft fibrosis
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发表于 2017-1-23 18:28