title: Monitoring the natural evolution and response to treatment of post liver transplant recurrent hepatitis C using transient elastography: preliminary results.
abstract: OBJECTIVE
  To perform a prospective analysis of changes in liver stiffness (LS) using transient elastography (TE) in a consecutive series of patients with post-liver transplant (LT) recurrent hepatitis C, either left to their natural evolution or receiving antiviral treatment.
  
  
  METHODS
  We examined the results from 17 comparisons of TE (baseline vs follow-up) from 11 patients. We evaluated: (1) upon inclusion in the study: age, sex, genotype, time transpired since LT, and baseline fibrosis (F0-4; Scheuer), and (2) during the follow-up period: time elapsed between the two TE and either specific treatment (B) or absence of treatment (A).
  
  
  RESULTS
  Mean patient age was 56.8 ± 7.9 years, with a male/female ratio of 10:1. Ten of the eleven patients had genotype 1b. The median time transpired between the LT and inclusion in the study was 28 months (range: 6-142 months). The mean time transpired between the two TE was 11.3 ± 4.5 months. In the 11 patients from group A (9 F1/2 F2; 13 "paired" TE), a predictable increase in LS was produced in 10 cases and a paradoxical result was produced in 3 cases. In the four patients in group B (3 F2/1 F1; 4 "paired" TE), a decrease in LS was produced in 3 cases and a paradoxical result in 1 case.
  
  
  CONCLUSIONS
  In our study of patients left to their natural evolution, a slow increase of LS was normal. However, antiviral treatment appeared to decrease LS. TE can be very useful as a complementary test to biopsy for monitoring post-LT recurrent hepatitis C. A longer follow-up period and larger sample size could confirm these preliminary results.
authors.affiliation: Hepatology Section, Gastrointestinal and Hepatical Department, Virgen del Rocío University Hospital, Seville. flbellido@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Bellido-Muñoz
authors.forename: A
authors.initials: A
authors.lastname: Giráldez-Gallego
authors.forename: C
authors.initials: C
authors.lastname: Roca-Oporto
authors.forename: T
authors.initials: T
authors.lastname: García-Cayuela
authors.forename: J M
authors.initials: JM
authors.lastname: Pascasio-Acevedo
authors.forename: J M
authors.initials: JM
authors.lastname: Sousa-Martín
mesh_terms: D054459:Elasticity Imaging Techniques; D005260:Female; D006526:Hepatitis C / Q000503:physiopathology*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence