title: Usefulness of acoustic radiation force impulse and fibrotest in liver fibrosis assessment after liver transplant.
abstract: Background and rationale. Acoustic radiation force impulse (ARFI) is a non-invasive tool used in the evaluation of liver fibrosis in HCV positive immune-competent patients. This study aimed to assess the accuracy of ARFI in discriminating liver transplanted patients with different graft fibrosis severity and to verify whether ARFI, eventually combined with non-invasive biochemical tests, could spare liver biopsies. This prospective study included 51 HCV positive liver transplanted patients who consecutively underwent to annual liver biopsy concomitantly with ARFI and blood chemistry tests measurements needed to calculate several non-invasive liver fibrosis tests.
  
  
  RESULTS
  Overall ARFI showed an AUC of 0.885 in discriminating between patients without or with significant fibrosis (Ishak score 0-2vs. 3-6). Using a cut-off of 1.365 m/s, ARFI possesses a negative predictive value of 100% in identifying patients without significant fibrosis. AUC for Fibrotest was 0.848 in discriminating patients with Ishak fibrosis score 0-2 vs. 3-6. The combined assessment of ARFI and Fibro-test did not improve the results obtained by ARFI alone.
  
  
  CONCLUSIONS
  ARFI measurement in HCV positive liver transplanted patients can be considered an easy and accurate non-invasive tool in identify patients with a benign course of HCV recurrence.
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Sara
authors: S
authors: Bignulin
authors: Pathology and Laboratory Medicine, Udine, Italy.
authors: Edmondo
authors: E
authors: Falleti
authors: Pathology and Laboratory Medicine, Udine, Italy.
authors: Sara
authors: S
authors: Cmet
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Dario
authors: D
authors: Cappello
authors: Pathology and Laboratory Medicine, Udine, Italy.
authors: Annarosa
authors: A
authors: Cussigh
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Ilaria
authors: I
authors: Lenisa
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Denis
authors: D
authors: Dissegna
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Fabio
authors: F
authors: Pugliese
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Cinzia
authors: C
authors: Vivarelli
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Carlo
authors: C
authors: Fabris
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Carlo
authors: C
authors: Fabris
authors: Department of Medical Sciences Experimental and Clinical, Medical Liver Transplant Section, Udine, Italy.
authors: Pierluigi
authors: P
authors: Toniutto
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D016632:Apolipoprotein A-I / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D054459:Elasticity Imaging Techniques; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008259:Macroglobulins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence
chemical_list: D016632:Apolipoprotein A-I; D006242:Haptoglobins; D008259:Macroglobulins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin