title: Graft function measured by transient elastography in living donor liver transplantation: preliminary.
abstract: BACKGROUND
  Liver stiffness measurements (LSMs) using transient elastography (TE) provide a noninvasive means to assess liver fibrosis that correlate with hepatic cholestasis. However, few studies have examined the correlation of TE to obtain LSMs with perioperative clinical and laboratory parameters in living donor liver transplantation (LDLT).
  
  
  METHODS
  We retrospectively reviewed forty-eight subjects who underwent LDLT between November 2010 and October 2012. All donors and recipients underwent TE, abdominal computed tomography (CT), and biochemical tests within 1 month before and at 1 week after transplantation. Using a cut-off LSM of 7.5 kPa, which we arbitrarily assigned to be indicative of significant fibrosis, we divided our study population into ≤7.5 kPa (group L; n = 15, 31.3%) versus >7.5 kPa; (group H; n = 33, 68.8%).
  
  
  RESULTS
  Pretransplantation serum total bilirubin, international normalized ratio, and Model for End-stage Liver Disease scores of recipients were significantly higher in group H than group L. Regarding the pretransplantation donor characteristics, the graft-recipient weight ratio was significantly smaller among those in group H (P = .039). In addition, the post-transplantation 1-week serum total bilirubin level was significantly higher in group H (2.3 mg/dL versus 1.2 mg/dL, P = .015), although neither biliary complications norhepatic congestion was identified by abdominal CT. Among the 1-week post-transplantation laboratory findings, only total bilirubin positively correlated with LSM (P = .044).
  
  
  CONCLUSIONS
  This pilot study suggested that a high LSM after LDLT suggests intrahepatic cholestasis and portal hypercirculation in the graft, irrespective of liver fibrosis, outflow obstruction, or biliary obstruction.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea; Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: D J
authors.initials: DJ
authors.lastname: Joo
authors.forename: S U
authors.initials: SU
authors.lastname: Kim
authors.forename: M S
authors.initials: MS
authors.lastname: Kim
authors.forename: A-L
authors.initials: AL
authors.lastname: Lee
authors.forename: G H
authors.initials: GH
authors.lastname: Choi
authors.forename: J S
authors.initials: JS
authors.lastname: Choi
authors.forename: K H
authors.initials: KH
authors.lastname: Han
authors.forename: S I
authors.initials: SI
authors.lastname: Kim
mesh_terms: D001663:Bilirubin / Q000097:blood; D054459:Elasticity Imaging Techniques; D005260:Female; D006085:Graft Survival; D006801:Humans; D019934:International Normalized Ratio; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D001663:Bilirubin