title: Non-invasive assessment of liver graft fibrosis by transient elastography after liver transplantation.
abstract: BACKGROUND
  Liver stiffness measurement (LSM) by transient elastography (TE) (FibroScan) is a validated method of quantifying liver fibrosis in non-transplanted patients with hepatitis C virus (HCV). It could be useful in follow-up after liver transplantation (LT). The aim of this study was to assess the diagnostic accuracy of LSM in evaluating liver fibrosis after LT in patients with and without recurrent HCV.
  
  
  METHODS
  Forty-three patients (mean age 57.6 ± 9.9 years), 28 (65.1%) HCV-positive patients and 15 (34.9%) HCV-negative patients underwent gold standard liver biopsy and TE 55.8 ± 4.9 months after transplantation. Liver fibrosis was scored on biopsy specimens according to METAVIR (F0-F4). Accuracy of TE and optimal stiffness cut-off values for fibrosis staging were determined by a receiver-operating characteristics (ROC) curve analysis.
  
  
  RESULTS
  Median stiffness values were significantly different for METAVIR score less than 2 (5.8 kPa) vs. METAVIR score greater to equal to 2 (9.6 kPa) (P<0.001). The area under the ROC curve was 0.83 for METAVIR score greater to equal to 2 (95%CI: 0.71-0.95). The optimal stiffness cut-off value was 7 kPa for METAVIR scores greater to equal to 2. The results were similar whether the patients had recurrent HCV infection or not.
  
  
  CONCLUSIONS
  These results indicate that transient elastography accurately identifies LT recipients with significant fibrosis, irrespective of HCV status. It is a promising non-invasive tool to assess graft fibrosis progression after LT in patients with HCV recurrence, as well as for screening of late graft fibrosis of other etiologies. Transient elastography could reduce the use of invasive protocol biopsies.
authors: Liver Transplantation Unit, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France. camille.barrault@chicreteil.fr
authors: Camille
authors: C
authors: Barrault
authors: Françoise
authors: F
authors: Roudot-Thoraval
authors: Jeanne
authors: J
authors: Tran Van Nhieu
authors: Calina
authors: C
authors: Atanasiu
authors: Michael D
authors: MD
authors: Kluger
authors: Fatiha
authors: F
authors: Medkour
authors: Catherine
authors: C
authors: Douvin
authors: Ariane
authors: A
authors: Mallat
authors: Elie-Serge
authors: ES
authors: Zafrani
authors: Daniel
authors: D
authors: Cherqui
authors: Christophe
authors: C
authors: Duvoux
mesh_terms: D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: HCC; HCV; Hepatitis C virus; Hepatocellular carcinoma; IQR; Interquartile range; KiloPascal; LSM; LT; Liver stiffness measurement; Liver transplant; ROC; Receiver-operating characteristics; TE; Transient elastography; kPa