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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
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Transient Elastography in Acute Cellular Rejection Following Liver Transplantation: Systematic Review.

L S Nacif1, C D C Gomes1, M N Mischiatti2

  • 1Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of São Paulo School of Medicine, Brazil.

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|April 18, 2018
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Summary

Transient elastography (TE) can assess liver stiffness to detect acute cellular rejection (ACR) after liver transplantation. Specific stiffness cutoff points show promise in identifying ACR severity, potentially reducing the need for biopsies.

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Diagnostic Imaging

Background:

  • Transient elastography (TE) noninvasively measures liver stiffness, indicating inflammation.
  • Acute cellular rejection (ACR) is an inflammatory response diagnosed via liver biopsy.
  • This review assesses TE's viability for diagnosing ACR post-liver transplantation.

Purpose of the Study:

  • To systematically review the effectiveness of transient elastography (TE) in diagnosing acute cellular rejection (ACR) following liver transplantation.
  • To evaluate the diagnostic accuracy of TE in assessing ACR severity.

Main Methods:

  • Systematic review of studies indexed in Cochrane Library, Embase, and PubMed up to November 2016.
  • Meta-analysis of three prospective studies involving 33 patients with ACR.
  • Analysis of liver stiffness measurements (kPa) using TE compared to liver biopsy results.

Main Results:

  • Three prospective studies were included in the meta-analysis.
  • TE showed elevated liver stiffness in ACR patients.
  • Identified potential cutoff points for TE: >7.9 kPa for graft damage, <5.3 kPa to exclude damage, and >8.5 kPa for moderate to severe ACR.

Conclusions:

  • Transient elastography shows potential as a tool for assessing ACR severity after liver transplantation.
  • Further research is needed to refine TE cutoff points and confirm its clinical applicability.