Assessment of liver stiffness in patients after living donor liver transplantation by transient elastography.
OBJECTIVE
Recurrence of hepatitis and progression of fibrosis are major problems in liver transplantation (LT) for patients with hepatitis C. Liver stiffness measurement (LSM) by transient elastography correlates well with histologic liver fibrosis stages in chronic liver diseases. The aim of this study was to evaluate the usefulness of transient elastography for the assessment of fibrosis in patients after living donor LT.


METHODS
Seventy-nine patients who visited our institution, and in whom LSM was successfully evaluated, were enrolled in the study. The patients were divided into three groups according to positivity for hepatitis C antibody and hepatitis B surface antigen as the hepatitis C virus (HCV) group (n=37), the hepatitis B virus (HBV) group (n=10), and the NBNC (negative for both hepatitis B and C) group (n=32). The correlation between LSM and histologic fibrosis stage was assessed in 36 patients. LSM was also compared with regard to the effect of interferon therapy in HCV patients.


RESULTS
The median value for liver stiffness was 6.8 kPa and the median time from LT was 3.1 years. In patients who underwent liver biopsy, stiffness was significantly correlated with the stages of fibrosis (p<0.001, rho = 0.848). In patients who received interferon therapy after LT, the LSM decreased over time in those with a sustained virological response, whereas LSM increased in patients without a response.


CONCLUSIONS
Transient elastography may be an appropriate non-invasive procedure to sequentially assess the progression of liver fibrosis in patients after LT.
Masuzaki
Ryota
R
Department of Gastroenterology, University of Tokyo, Japan.
Yamashiki
Noriyo
N
Sugawara
Yasuhiko
Y
Yoshida
Haruhiko
H
Tateishi
Ryosuke
R
Tamura
Sumihito
S
Kaneko
Junichi
J
Hasegawa
Kiyoshi
K
Kokudo
Norihiro
N
Makuuchi
Masatoshi
M
Omata
Masao
M
D000704:Analysis of Variance; D001706:Biopsy; D016009:Chi-Square Distribution; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors