Liver Elastography in Acute Cellular Rejection After Liver Transplantation
Lucas Souto Nacif1, Caroline de Cassia Gomes1, Denise Paranaguá-Vezozzo1
1Liver and Gastrointestinal Transplant Division. Department of Gastroenterology, University of São Paulo School of Medicine, Brazil.
Transplantation Proceedings
|March 29, 2020
Summary
Transient elastography, a noninvasive liver stiffness measurement, shows significant correlation with acute cellular rejection (ACR) after liver transplantation. This method offers a valuable tool for diagnosing ACR, potentially reducing the need for invasive liver biopsies.
Area of Science:
- Hepatology
- Transplant Surgery
- Diagnostic Imaging
Background:
- Transient elastography is a noninvasive technique for assessing liver stiffness.
- Acute cellular rejection (ACR) is a primary complication following liver transplantation.
- Liver biopsy, the current gold standard for ACR diagnosis, is invasive and carries risks.
Purpose of the Study:
- To evaluate the efficacy of transient elastography in diagnosing acute cellular rejection (ACR) post-liver transplantation.
- To compare elastography findings with liver biopsy results in transplant recipients.
Main Methods:
- A prospective, comparative study involving liver transplant patients from January 2017 to March 2019.
- Patients were categorized into ACR and non-ACR groups based on liver biopsy.
- Liver elastography (FibroScan, ARFI), laboratory tests, and ultrasound were analyzed using the Mann-Whitney U test.
Main Results:
- The study included 40 patients, with 25 diagnosed with ACR.
- Significant differences were observed in total bilirubin, direct bilirubin, AST, ALT, and GGT between ACR and non-ACR groups.
- Mean FibroScan values were higher in the ACR group (12.5 kPa) compared to the non-ACR group (8.9 kPa), with a P-value of .05. ARFI values did not show significant differences.
- Receiver operator characteristic curve analysis for FibroScan in ACR demonstrated an AUC of 0.688.
Conclusions:
- Transient elastography, particularly FibroScan, is a valuable noninvasive tool for detecting acute cellular rejection (ACR).
- A significant correlation exists between hepatic elastography values and the presence of ACR, supporting its use in clinical practice.
