Assessment of Graft Fibrosis by Transient Elastography in Patients With Recurrent Hepatitis C After Living Donor Liver Transplantation

Harada, Noboru; Soejima, Yuji; Taketomi, Akinobu; Yoshizumi, Tomoharu; Ikegami, Toru; Yamashita, Yo Ichi; Itoh, Shinji; Kuroda, Yasuhiro; Maehara, Yoshihiko

doi:10.1097/01.tp.0000297248.18483.16

Cited by 89 publications

(107 citation statements)

References 16 publications

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“…30 We chose to adopt serum fibrosis biomarkers computed at 1 year after LT to predict clinical outcomes, given that HCV and NASH, among the most common indications for LT, often recur within 1 year after LT. 8 Additionally, it is known that thrombocytopenia due to hypersplenism and low thrombopoietin resolves in close to 90% of individuals (if no recurrence of liver disease) at 1 year after LT. 24 In our study, the diagnostic performance of serum fibrosis biomarkers to predict presence of significant liver fibrosis was similar to that reported in studies in pretransplant patients. 11 Moreover, our findings are in line with previous studies conducted in the posttransplant setting, and the AUROC was 0.68-0.80 for APRI 18,20,31,32 and 0.66 for FIB-4 32 to diagnose significant liver fibrosis in patients with recurrent HCV.…”

Section: Discussionsupporting

confidence: 81%

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

et al. 2015

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Noninvasive serum fibrosis biomarkers predict clinical outcomes in pretransplant patients with chronic liver disease. We investigated the role of serum fibrosis biomarkers and of changes in biomarkers in predicting death and graft loss after liver transplantation (LT). We included 547 patients who underwent LT between 1991 and 2012 and who met the following criteria: patient and graft survival > 12 months; serum fibrosis biomarkers aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis score 4 (FIB-4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score available at 1 year after LT; and a minimum follow-up of 1 year. Delta of fibrosis biomarkers was defined as (end of follow-up score -baseline score)/followup duration. Baseline and delta fibrosis biomarkers were associated with death: APRI > 1.5 (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.4-3.3; P < 0.001) and delta APRI > 0.5 (aHR, 5.3; 95% CI, 3.4-8.2; P < 0.001); FIB-4 > 3.3 (aHR, 1.9; 95% CI, 1.3-2.8; P 5 0.002) and delta FIB-4 > 1.4 (aHR, 2.4; 95% CI, 1.4-4.1; P 5 0.001); and NAFLD fibrosis score > 0.7 (aHR, 1.9; 95% CI, 1.3-2.9; P 5 0.002) and delta NAFLD fibrosis score (aHR, 3.7; 95% CI, 2.6-5.4; P < 0.001). Baseline and delta fibrosis biomarkers were associated also with graft loss. In conclusion, serum fibrosis biomarkers 1 year after LT and changes in serum fibrosis biomarkers predict death and graft loss in LT recipients. They may help in risk stratification of LT recipients and identify patients requiring closer monitoring.

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Section: Discussionsupporting

confidence: 81%

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

et al. 2015

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“…However, liver stiffness measurement (LSM) cannot yet confidently predict the presence of esophageal varices in clinical practice and thus avoid the need for upper GI endoscopic screening of cirrhotic patients [85]. TE could be also valuable for assessing the severity of recurrent hepatitis C after liver transplantation, reducing the need for follow-up liver biopsies [78,[86][87][88][89][90]. It has been recently suggested that TE may perform better for significant fibrosis than serum (direct and indirect) biomarkers [91].…”

Section: Monitoring Of Disease Progressionmentioning

confidence: 99%

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Castéra

2011

Hepatol Int

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“…Of these, Cescon et al [22] and Wong et al [24] tested the predictive performance of TE for postoperative hepatic insufficiency and failure after hepatic resection. Additionally, several studies proved that TE is useful in predicting the severity of liver fibrosis progression due to recurrent hepatitis C virus (HCV) infection after transplantation [25,26,27,28]. If future studies validate the usefulness of TE values in the surgical field, TE will rapidly facilitate the risk stratification of patients undergoing surgical management according to different prognoses assessed by this approach.…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Liver Stiffness Measurement Using Transient Elastography: A Surgical Perspective

Kim¹,

Han²

2013

Digestion

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Liver biopsy (LB) remains the gold standard for assessing the severity of liver fibrosis; however, LB is often limited by its invasiveness, sampling error, and intra-/inter-observer variability in histological interpretation. Furthermore, repeated LB examinations within a short time interval are ineligible in real clinical practice. Thus, due to the pressing need for non-invasive surrogates, over the past decade, significant progress has been made in non-invasively assessing liver fibrosis. Of the methods now available, transient elastography (TE) appears to be an excellent tool for assessing liver fibrosis and also has some prognostic value in surgical settings. Recent studies have proposed the extended role of TE in the surgical field, based on the concept that TE values show significant correlations with portal hypertension and hepatocellular carcinoma development. TE appears promising in predicting postoperative short-term outcomes such as hepatic insufficiency or complications and long-term outcomes such as recurrence or liver-related death. Furthermore, TE may be useful in predicting the severity of liver fibrosis progression due to recurrence of hepatitis C virus infection or other underlying liver diseases after transplantation. TE cannot completely replace other tests accompanied with hepatic surgical treatments, including LB, endoscopic examination, hepatic venous pressure gradient evaluation, or the indocyanine green retention test. However, TE represents an important non-invasive tool that enables more efficient and tailored management strategies for patients who were treated with liver resection or transplantation. This review discusses extended TE applications in the surgical setting, such as hepatic resection or transplantation.

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Assessment of Graft Fibrosis by Transient Elastography in Patients With Recurrent Hepatitis C After Living Donor Liver Transplantation

Abstract: These data suggest that transient elastography is a simple, noninvasive and reliable tool to assess liver fibrosis in patients with recurrent hepatitis C virus after living donor liver transplantation.

Cited by 89 publications

References 16 publications

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Clinical Application of Liver Stiffness Measurement Using Transient Elastography: A Surgical Perspective

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