Transient elastography predicts fibrosis progression in patients with recurrent hepatitis C after liver transplantation

Rigamonti, Cristina; Donato, Maria Francesca; Fraquelli, Mirella; Agnelli, F.; Ronchi, G.; Casazza, Giovanni; Rossi, G.; Colombo, Massimo

doi:10.1136/gut.2007.135046

Cited by 135 publications

(138 citation statements)

References 41 publications

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“…TE, a recently developed, simple and noninvasive technique to measure hepatic stiffness, has been shown to be a reliable tool to estimate the degree of hepatic fibrosis in patients with chronic liver disease, mainly in those with chronic HCV infection [11][12][13][14][15][16][17][18][19][20][21][22]. In b-thalassemia patients (especially those HCV infected) at higher risk of liver biopsy related complications as compared to other chronically HCV-infected patients, the availability of a noninvasive method to measure hepatic fibrosis is crucial.…”

Section: Discussionmentioning

confidence: 99%

“…The measurement of the speed of propagation of the wave across the hepatic parenchyma provides an estimate of the liver elasticity, which is a surrogate marker of liver fibrosis [8][9][10]. In studies comparing the results of TE versus liver biopsy as the reference standard, TE showed a satisfactory accuracy in identifying patients with chronic liver disease (CLD) accompanied by significant fibrosis or cirrhosis and it has been shown to have a good interobserver and intraobserver reproducibility [11][12][13][14][15][16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Transient elastography in the assessment of liver fibrosis in adult thalassemia patients

et al. 2010

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Transient elastography (TE) is a valuable noninvasive technique of measuring liver stiffness and a reliable tool for predicting hepatic fibrosis in patients with chronic liver disease. The role of TE in patients with β‐thalassemia has not been extensively investigated. The present study aimed to evaluate the role of TE in the assessment of hepatic fibrosis in 115 adult patients with β‐thalassemia major (TM) (#59) or intermedia (TI) (#56). TE was performed according to current practice. Histologic data were obtained in 14 cases. Liver iron concentration was assessed by atomic absorption spectrometry and T2* magnetic resonance. In patients with TM, the proportion of anti‐HCV positive viremic patients, median serum ferritin levels, and TE values were significantly higher than in TI. In the group of 14 patients who underwent liver biopsy, a significant positive correlation was observed between liver stiffness and fibrosis stage (r = 0.73, P = 0.003). Severe fibrosis is diagnosed with a sensitivity of 60% and a specificity of 89%, whereas cirrhosis is detected with a sensitivity of 100% and a specificity of 92%. At multivariate analysis, the variables independently associated with TE were ALT, GGT, and bilirubin levels in both groups and, in patients with TM, HCV RNA positivity. In β‐thalassemia patients, TE is a reliable tool for assessing liver fibrosis even if the influence of iron overload has to be clarified. Am. J. Hematol. 85:564–568, 2010. © 2010 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transient elastography in the assessment of liver fibrosis in adult thalassemia patients

et al. 2010

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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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“…Similarly, LSM has proven to be useful to assess histological progression after transplantation (13,14). However, to date, no study has evaluated the association between liver stiffness and clinical events, including graft and patient survival, in recurrent hepatitis C following LT. Only a score comprising three direct serum biomarkers proved helpful to predict the development of clinical decompensations and graft loss in this setting (15), though these markers have not been validated so far.…”

Section: Introductionmentioning

confidence: 99%

Liver Stiffness 1 Year After Transplantation Predicts Clinical Outcomes in Patients With Recurrent Hepatitis C

Crespo

Lens

Gambato

et al. 2014

American Journal of Transplantation

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The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C-infected and 48 non-hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) <8.7 kilopascals (kPa) versus 47% for patients with LSM ! 8.7 kPa (p < 0.001). Five-year graft and patient cumulative survival were 90% and 92% in patients with LSM < 8.7 kPa (p < 0.001) and 63% and 64% in patients with LSM ! 8.7 kPa, respectively (p < 0.001). Patients with low LSM 1 year after LT had excellent outcomes independently from receiving antiviral treatment or achieving sustained virological response (SVR). In contrast, graft survival significantly improved in patients with LSM ! 8.7 kPa who achieved SVR. No association between outcomes and LSM at 12 months was observed in non-HCV patients. In conclusion, LSM 1 year after LT is a valuable tool to predict hepatitis C-related outcomes in recurrent hepatitis C and can be used in clinical practice to identify the best candidates for antiviral therapy.

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Transient elastography predicts fibrosis progression in patients with recurrent hepatitis C after liver transplantation

Abstract: TE accurately predicts fibrosis progression in LT patients with recurrent hepatitis C, suggesting that protocol LB might be avoided in patients with improved or stable TE values during follow-up.

Cited by 135 publications

References 41 publications

Transient elastography in the assessment of liver fibrosis in adult thalassemia patients

Transient elastography in the assessment of liver fibrosis in adult thalassemia patients

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Liver Stiffness 1 Year After Transplantation Predicts Clinical Outcomes in Patients With Recurrent Hepatitis C

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