Evaluation of Etiology Based on Post-Transplant Pathological Diagnosis in Cases of Cryptogenic Cirrhosis

Transplant Proc. 2025 Nov;57(9):1788-1792. doi: 10.1016/j.transproceed.2025.08.012. Epub 2025 Sep 16.

Abstract

Aim: This study aimed to present etiological insights by evaluating the histopathological findings of patients who underwent liver transplantation for cryptogenic cirrhosis (CC).

Patients and methods: We retrospectively analyzed patients who underwent liver transplantation with a preoperative diagnosis of CC at our center between February 1997 and 2024. Clinical and pathological data were recorded, survival analyses were conducted, and statistical comparisons were performed.

Results: Among 66 patients preoperatively diagnosed with CC, a specific etiology was identified in 13 (%19.6) cases, while the remaining 53 (%80.4) were classified as CC. The median patient age was 49 years, with a mean BMI of 25.7. Type 2 diabetes was present in 22.6% of cases, and obesity in 13.2%. The mean follow-up period was 139 months, the median MELD score was 16, the incidence of hepatocellular carcinoma was 6%, and total mortality was recorded in 19 (%35.8) patients. The survival rates at 1, 3, 5, and 10 years were calculated as 87%, 81%, 79.2%, and 74.3%, respectively. While type 2 diabetes did not significantly affect survival (P = .78), obesity was found to be associated with a significantly lower survival rate (P = .001).

Conclusion: Although CC is widely considered the advanced stage of a metabolic syndrome-related liver disease, our findings do not fully support this hypothesis. Therefore, further research is needed to investigate other potential contributing factors in the etiology of CC.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular
  • Diabetes Mellitus, Type 2 / complications
  • Female
  • Humans
  • Liver Cirrhosis* / congenital
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / etiology
  • Liver Cirrhosis* / mortality
  • Liver Cirrhosis* / pathology
  • Liver Cirrhosis* / surgery
  • Liver Neoplasms
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Obesity / complications
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Supplementary concepts

  • Cirrhosis, Cryptogenic