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Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)

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Abstract

Liver fibrosis is a common pathway leading to cirrhosis, which is the final result of injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Liver biopsy has been considered to be the “gold standard” to assess fibrosis. However, liver biopsy being invasive and, in many instances, not favored by patients or physicians, alternative approaches to assess liver fibrosis have assumed great importance. Moreover, therapies aimed at reversing the liver fibrosis have also been tried lately with variable results. Till now, there has been no consensus on various clinical, pathological, and radiological aspects of liver fibrosis. The Asian Pacific Association for the Study of the Liver 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 process for the development of these consensus guidelines involved the following: review of all available published literature by a core group of experts; proposal of consensus statements by the experts; discussion of the contentious issues; and unanimous approval of the consensus statements after discussion. The Oxford System of evidence-based approach was adopted for developing the consensus statements using the level of evidence from 1 (highest) to 5 (lowest) and grade of recommendation from A (strongest) to D (weakest). The consensus statements are presented in this review.

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  1. GI and Liver Unit, Internal Medicine Department, Almansoura Faculty of Medicine, Almansoura University, Almansoura, 35516, Egypt

    Gamal Shiha, Shiv Kumar Sarin, Alaa Eldin Ibrahim, Masao Omata, Ashish Kumar, Laurentius A. Lesmana, Nancy Leung, Nurdan Tozun, Saeed Hamid, Wasim Jafri, Hitoshi Maruyama, Pierre Bedossa, Massimo Pinzani, Yogesh Chawla, Gamal Esmat, Wahed Doss, Taher Elzanaty, Puja Sakhuja, Ahmed Medhat Nasr, Ashraf Omar, Chun-Tao Wai, Ahmed Abdallah, Mohsen Salama, Abdelkhalek Hamed, Ayman Yousry, Imam Waked, Medhat Elsahar, Amr Fateen, Sherif Mogawer, Hassan Hamdy & Reda Elwakil

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Consortia

Jury of the APASL Consensus Development Meeting 29 January 2008 on Liver Fibrosis With Without Hepatitis B or C

Corresponding author

Correspondence to Gamal Shiha.

Additional information

The members of Jury of the APASL Consensus Development Meeting are given in Appendix 1.

Appendix 1

Appendix 1

Egyptians: Abdelrhman Elzayadi, Abdelhamid Abaza, Abdelkhalek Hamed, Abdelrhman Zekry, Abueldahab Elsahly, Ahmed Eldorry, Bahaa Abass, Basma Samir, Emad Barakat, Eman Rewisha, Fayza Azzam, Hassan Elshenawy, Inas El-Korimi, Khaled Hemedah, Helmy Abaza, Khaled Zalata, Mazen Naga, Magdy Atta, Mamdouh Gabr, Mohamed Amer Afefy, Mohamed Elateek, Mohamed El-Khashab, Mohamed Sharaf Eldin, Mohsen Maher, Mostafa Elawady, Mostafa Gabr, Omar Haikal, Rasheed Bahgat, Sherif Abdelfattah, Taghreed Gaafar, Tawheed Mowafy, Yousry Taher.

International: Abdelatif Charqawi (Morocco), Abdul-Naser Elzouki (Libya), Ali Elsaid (UAE), Hasnain Ali Shah (Pakistan), Mamun-Al-Mahtab (Bangladesh), Nizar Zein (USA), Salem Awad (UAE).

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Shiha, G., Sarin, S.K., Ibrahim, A.E. et al. Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL). Hepatol Int 3, 323–333 (2009). https://doi.org/10.1007/s12072-008-9114-x

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