PMID- 33636655 OWN - NLM STAT- MEDLINE DCOM- 20220110 LR - 20220110 IS - 2210-741X (Electronic) IS - 2210-7401 (Linking) VI - 45 IP - 4 DP - 2021 Jul TI - Prevalence and clinical characteristics of alpha-1 antitrypsin deficiency in liver explants in a Mexican cohort. PG - 101519 LID - S2210-7401(20)30214-X [pii] LID - 10.1016/j.clinre.2020.07.024 [doi] AB - INTRODUCTION: Alpha-1 antitrypsin deficiency (AATD) is a risk factor for liver disease. PASD-positive inclusions have been found unexpectedly in approximately 10% of liver explants in patients with no previous diagnosis of AATD, particularly, in patients with non-alcoholic steatohepatitis (NASH), supporting a synergistic mechanism of liver injury between AATD and environmental factors. We aimed to determine the clinical characteristics of mestizo patients in which AATD was diagnosed before or after liver transplantation. METHODS: Liver explants of patients with cryptogenic, alcoholic, and NAFLD/NASH cirrhosis undergoing orthotopic liver transplantation (OLT) were included. Liver histopathology was assessed by two expert pathologists. Hematoxylin and eosin staining, PASD staining, and confirmatory AAT immunohistochemistry were performed. In explants with positive histopathology, genotyping for SERPINA1 was performed. RESULTS: A total of 180 liver transplants were performed during the study period. Of these, 44 patients with cryptogenic cirrhosis, NASH, and alcoholic cirrhosis were included. Of these patients, two liver explants (4.5%) had PASD-positive inclusions stain and confirmatory immunochemistry. During the period evaluated, another two patients with a diagnosis of AATD before the OLT were also included. The four patients had overweight or obesity, three had type 2 diabetes mellitus, and two developed liver steatosis after the OLT. CONCLUSION: AATD was found to be an infrequent finding in patients with cryptogenic, NASH/NAFLD, and alcoholic cirrhosis in our population. However, it is important to consider this entity as it may represent an additional factor in the appearance and progression of liver fibrosis in patients with metabolic syndrome. CI - Copyright (c) 2020 Elsevier Masson SAS. All rights reserved. FAU - Campos-Murguia, Alejandro AU - Campos-Murguia A AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. FAU - Valdez-Hernandez, Pedro AU - Valdez-Hernandez P AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. FAU - Cordova-Gallardo, Jacqueline AU - Cordova-Gallardo J AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. FAU - Arteaga-Vazquez, Jazmin AU - Arteaga-Vazquez J AD - Department of Genetics, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Contreras, Alan G AU - Contreras AG AD - Department of Tranplant, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Vilatoba, Mario AU - Vilatoba M AD - Department of Tranplant, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Cruz-Martinez, Rodrigo AU - Cruz-Martinez R AD - Department of Tranplant, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Martinez-Benitez, Braulio AU - Martinez-Benitez B AD - Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Gamboa-Dominguez, Armando AU - Gamboa-Dominguez A AD - Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Mexico City, Mexico. FAU - Marfil-Garza, Braulio A AU - Marfil-Garza BA AD - Alberta Diabetes Institute, Alberta, Canada. FAU - Flores-Garcia, Nayelli C AU - Flores-Garcia NC AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. FAU - Marquez-Guillen, Ernesto AU - Marquez-Guillen E AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. FAU - Garcia-Juarez, Ignacio AU - Garcia-Juarez I AD - Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", Av. Vasco de Quiroga 15, colonia Belisario Dominguez Seccion XVI, Tlalpan, 14080 Mexico City, Mexico. Electronic address: drinter77@gmail.com. LA - eng PT - Journal Article DEP - 20210223 PL - France TA - Clin Res Hepatol Gastroenterol JT - Clinics and research in hepatology and gastroenterology JID - 101553659 SB - IM MH - *Diabetes Mellitus, Type 2 MH - Humans MH - Liver Cirrhosis MH - Liver Cirrhosis, Alcoholic MH - *Non-alcoholic Fatty Liver Disease/epidemiology MH - Prevalence MH - *alpha 1-Antitrypsin Deficiency/complications/diagnosis/epidemiology OTO - NOTNLM OT - Alpha-1 antitrypsin OT - Liver transplant OT - Mestizo OT - Mexico OT - Steatosis EDAT- 2021/02/27 06:00 MHDA- 2022/01/11 06:00 CRDT- 2021/02/26 20:18 PHST- 2020/06/24 00:00 [received] PHST- 2020/07/29 00:00 [revised] PHST- 2020/07/31 00:00 [accepted] PHST- 2021/02/27 06:00 [pubmed] PHST- 2022/01/11 06:00 [medline] PHST- 2021/02/26 20:18 [entrez] AID - S2210-7401(20)30214-X [pii] AID - 10.1016/j.clinre.2020.07.024 [doi] PST - ppublish SO - Clin Res Hepatol Gastroenterol. 2021 Jul;45(4):101519. doi: 10.1016/j.clinre.2020.07.024. Epub 2021 Feb 23.