Non-invasive assessment of liver fibrosis by transient elastography in post transfusional iron overload.
BACKGROUND
Liver fibrosis, assessed by biopsy, is the main complication of post transfusional liver iron overload. Transient elastography (TE) is a new, non invasive method able to measure liver stiffness (LS) caused by fibrosis.


METHODS
We prospectively evaluated the predictive value of LS measurement for liver fibrosis evaluation in 15 chronically transfused patients and compared these results with the METAVIR histological fibrosis stage from liver biopsies.


RESULTS
Mean TE values significantly differed in patients with severe fibrosis (METAVIR F3, F4): 9.1 (+/-3.7 SD) kPa from those with mild or no fibrosis (METAVIR F0, F1, F2): 5.9 (+/-1.8 SD) kPa (P = 0.046). TE value above 6.25 kPa (Se = 80%; Sp = 70%; AUROC = 0.820) identified patients at risk for severe fibrosis (Negative Predictive Value 88%; Positive Predictive Value 57%).


CONCLUSIONS
Transient elastography appears to be a reliable tool to evaluate liver fibrosis in post-transfusional iron overload.
Mirault
Tristan
T
Service d'Hématologie, Hôpital Saint Vincent de Paul, Université Catholique de Lille, Lille, France.
Lucidarme
Damien
D
Turlin
Bruno
B
Vandevenne
Philippe
P
Gosset
Pierre
P
Ernst
Olivier
O
Rose
Christian
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D002648:Child; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D019190:Iron Overload / Q000150:complications / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged