title: Hepatitis C virus reinfection in liver transplant patients: evaluation of liver damage progression with echo-color Doppler.
abstract: Liver transplant recipients are a model of rapid progression of hepatitis C virus (HCV)-related liver disease, from normal to cirrhosis. The aim of the study was the analysis of the relationship between portohepatic hemodynamics and modification in liver histology during the progression of HCV liver disease after transplant. Patients transplanted for HCV cirrhosis were considered for the study. At least every 6-12 months, the portal blood flow velocity, hepatic and splenic pulsatility indices, and a portal hypertensive index (obtained from the combination of the portal blood velocity and splenic pulsatility index) were measured with echo-Doppler. Liver biopsy was performed whenever necessary. The time course of echo-Doppler parameters during the histological progression of the liver disease was analyzed. Posttransplant patients without HCV were included as controls. Forty-nine patients with histology-proven relapse of HCV hepatitis were included in the study. At the onset of recurrent hepatitis, the portal blood flow velocity significantly decreased (P < 0.001), and the splenic pulsatility index increased (P = 0.020), whereas the hepatic pulsatility index remained unchanged. In the following years, in addition to a further slight decrease in the portal blood velocity (P = 0.027), a progressive increase in the hepatic and splenic pulsatility indices was also detected (P = 0.009 and P < 0.0001, respectively). The portal hypertensive index steadily increased with the progression of the disease and was related to the degree of liver fibrosis. In conclusion, the information obtainable from splanchnic Doppler parameters can be used to monitor the progression of liver fibrosis in transplant patients with HCV reinfection.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy. massimo.bolognesi@unipd.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Bolognesi
authors.forename: Cristina
authors.initials: C
authors.lastname: Quaglio
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Bombonato
authors.forename: Maria
authors.initials: M
authors.lastname: Guido
authors.forename: Luisa
authors.initials: L
authors.lastname: Cavalletto
authors.forename: Liliana
authors.initials: L
authors.lastname: Chemello
authors.forename: Carlo
authors.initials: C
authors.lastname: Merkel
authors.forename: Massimo
authors.initials: M
authors.lastname: Rugge
authors.forename: Angelo
authors.initials: A
authors.lastname: Gatta
authors.forename: David
authors.initials: D
authors.lastname: Sacerdoti
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006526:Hepatitis C / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000821:virology; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology; D012008:Recurrence; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D013152:Splanchnic Circulation; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color