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Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update

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单位: [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 medicine, University of Benha, Benha, Egypt [4]Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), New Delhi, India [5]Department of Gastroenterology, University of Tokyo, Tokyo, Japan [6]Department of Tropical Medicine & Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt [7]Department of Gastroenterology & Hepatology, Ganga Ram Institute for Postgraduate Medical Education & Research of Sir Ganga Ram Hospital, New Delhi, India [8]Division of Hepatology, North Shore University Hospital and Long Island Jewish Medical Center, New Hyde Park, New York, USA [9]Department of Gastroenterology, Chiba University Graduate School of Medicine, Chiba, Chiba Prefecture, Japan [10]Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India [11]Post Graduate Institute of Medial Education & Research, Chandigarh, India [12]Department of Medicine, The Aga Khan University & Hospital, Stadium Road, 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, Espan˜a Blvd, 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 Medicine, Taif University, Taif, 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, CA, 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
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关键词: Liver fibrosis Invasive assessment non-invasive assessment Cirrhosis Hepatitis C Hepatitis B Chronic liver disease Non-alcoholic steatohepatitis Graft fibrosis

摘要:
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.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 胃肠肝病学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
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出版当年[2015]版:
Q4 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2015版] 出版当年五年平均[2011-2015] 出版前一年[2014版] 出版后一年[2016版]

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第一作者单位: [1]Internal Medicine Department, El-Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt [2]Egyptian Liver Research Institute And Hospital (ELRIAH), Mansoura, Egypt
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通讯机构: [1]Internal Medicine Department, El-Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt [2]Egyptian Liver Research Institute And Hospital (ELRIAH), Mansoura, Egypt
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