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

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

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.

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).

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.