studies

870A AASLD ABSTRACTS HEPATOLOGY, October, 2015
1343
Effects of Alcohol and Abstinence on Liver Stiffness as
measured by Transient Elastography
Izabella Pokorski 1 , Yang Wu 2 , Martin Weltman 2 , Guy D. Eslick 3 ;
1 Centre for Addiction Medicine, Nepean Blue Mountains Local
Health District, Penrith, NSW, Australia; 2 Gastroenterology and
Hepatology, Nepean Hospital, Penrith, NSW, Australia; 3 Surgery,
The University of Sydney, Penrith, NSW, Australia
The purpose of this study is to examine the relationship between
alcohol consumption, monitored abstinence, relapse and liver
stiffness as measured by Transient Elastogprahy (TE) to elucidate
the best time to accurately record liver fibrosis in patients
with Alcoholic Liver Disease (ALD). TE is a potential alternative
to biopsy to measure liver stiffness, an indirect estimation of
liver fibrosis. Patients presenting for voluntary detoxification
of their alcohol dependence at Nepean Hospital were consecutively
approached from June 2014 until May 2015. Liver
stiffness measurements were recorded on admission, discharge
and at least 7 days post discharge. Relapse information after
discharge was recorded. Blood tests as well as BMI, hepatitis
B and C status were collated for sub-analysis. 123 patients
were recruited.13% were excluded due to their body habitus
and early discharge limited second scan data. 76% of participants
were male (53/70) and 24% of participants were female
(17/70). 70 patients had 2 valid scans, with an average mean
reduction of -2.25kPa in liver stiffness from day of admission
to second TE scan (statistically significant P>0.001). 47% of
patients showed a decrease in at least 1 fibrosis stage (statistically
significant P < 0.001).The average length between admission
and discharge scan was 4 days (range 1-31). Patients
were put into 2 groups based on days between TE scans (3
days and under, more than 3 days). The difference in TE score
for patients who were scanned after 3 days and above was
more statistically significant (P < 0.001) compared to patients
scanned in 3 days and under (P =0.004). 19 (27%) patients
attended a third follow-up scan with a mean time of 96 days
from discharge. Difference in measurements was not statistically
significant. Fibrosis severity among patients with ALD not
infected with HCV (n=40) was variable (F0-1 = 55%, F2-F3
= 35%, F4 = 10%). 19% of patients reported having been
diagnosed with HCV with 46% of these patients initially found
to have cirrhosis (14.8kPa – 66.4 kPa). The study suggests that
liver stiffness as measured by TE declines in patients with ALD,
Hepatitis C and Cirrhosis while undergoing monitored abstinence
from alcohol. A decrease in stage of fibrosis is clinically
significant. The small number of patients presenting for a third
TE scan after discharge (n=19) has made it difficult to evaluate
the effect of relapse of alcohol consumption. However, it is
clear that ongoing consumption of alcohol facilitates over-reading
of TE scores. To obtain the most accurate TE reading, a
scan should be performed at least 3-5 days post complete
alcohol abstinence.
Disclosures:
The following authors have nothing to disclose: Izabella Pokorski, Yang Wu,
Martin Weltman, Guy D. Eslick
1344
Microparticles Are Markers Of Immune Cell Stress And
Predict Severity And Outcomes In Patients With Alcoholic
Liver Disease
Sukriti Sukriti 1 , Jaswinder S. Maras 1 , Shvetank Sharma 1 , Madhumita
Premkumar 2 , Sukanta Das 1 , Shabir Hussain 1 , Guresh Kumar 1 ,
Naminita Gogoi 3 , Ashok K. Choudhury 2 , Chinmay Mukhopadhyay
3 , Nirupma Trehanpati 1 , Shiv K. Sarin 1,2 ; 1 Research, Institute
of Liver and Biliary Sciences, New Delhi, India; 2 Hepatology,
Institute of Liver and Biliary Sciences, New Delhi, India; 3 Special
Center for Molecular Medicine, JNU, New Delhi, India
Background and Aims: Microparticles (MPs) are the membrane
bound vesicles released during cellular stress. Disease
specific MP signatures may aid disease progression or treatment
outcomes. Severe alcoholic hepatitis (SAH) has a rapid
progression and poor response to current therapies. Reliable
tools, preferably noninvasive, are needed for early assessment
of progression and treatment response. We investigated the
correlation between MPs released in SAH, steroid responders
(R) and non-responders (NR). Patients and Methods: MPs
were isolated from plasma using differential ultracentrifugation
followed by flow cytometry. MPs were enumerated by addition
of known size beads (0.22,0.44,0.88,1.45um). This size
gate was combined with Annexin V staining and, various cell
specific markers were used. Reference counting beads were
added to determine absolute count of MPs/ml. MPs were determined
at day 0 and 7 in all 40 patients with SAH; untreated
(n=8), steroid responder (R)(n=20), NR (n=12), and healthy
controls (n=20). The MP counts were correlated with MELD
score, Lille score, serum bilirubin and ALT/AST. Results: MPs
associated with HSCs (CD34+), macs (CD68+) and Tcells
(CD3+CD8+) were higher in NR at day0 (p