title: Liver stiffness 1 year after transplantation predicts clinical outcomes in patients with recurrent hepatitis C.
abstract: The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C-infected and 48 non-hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) <8.7 kilopascals (kPa) versus 47% for patients with LSM ≥ 8.7 kPa (p<0.001). Five-year graft and patient cumulative survival were 90% and 92% in patients with LSM<8.7 kPa (p<0.001) and 63% and 64% in patients with LSM ≥ 8.7 kPa, respectively (p<0.001). Patients with low LSM 1 year after LT had excellent outcomes independently from receiving antiviral treatment or achieving sustained virological response (SVR). In contrast, graft survival significantly improved in patients with LSM ≥ 8.7 kPa who achieved SVR. No association between outcomes and LSM at 12 months was observed in non-HCV patients. In conclusion, LSM 1 year after LT is a valuable tool to predict hepatitis C-related outcomes in recurrent hepatitis C and can be used in clinical practice to identify the best candidates for antiviral therapy.
authors.affiliation: Liver Unit, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Crespo
authors.forename: S
authors.initials: S
authors.lastname: Lens
authors.forename: M
authors.initials: M
authors.lastname: Gambato
authors.forename: J A
authors.initials: JA
authors.lastname: Carrión
authors.forename: Z
authors.initials: Z
authors.lastname: Mariño
authors.forename: M-C
authors.initials: MC
authors.lastname: Londoño
authors.forename: R
authors.initials: R
authors.lastname: Miquel
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: M
authors.initials: M
authors.lastname: Navasa
authors.forename: X
authors.initials: X
authors.lastname: Forns
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016174:Hepacivirus / Q000472:pathogenicity; D006526:Hepatitis C / Q000188:drug therapy* / Q000601:surgery* / Q000821:virology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012008:Recurrence; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: Graft loss; prognosis; recurrent hepatitis C; transient elastography