title: Serial Liver Stiffness Measurements and Monitoring of Liver-Transplanted Patients in a Real-Life Clinical Practice.
abstract: BACKGROUND
  Liver transplanted patients need close surveillance for early signs of graft disease.
  
  
  OBJECTIVE
  Transient elastography can safely be repeated over time, offering serial liver stiffness measurement values. Serial stiffness measurements were compared to single baseline stiffness measurements in predicting the appearance of liver-related clinical events and guiding subsequent clinical decisions.
  
  
  METHODS
  One hundred and sixty liver transplanted patients were observed for three years in our real-life practice.
  
  
  RESULTS
  Liver stiffness measurements were stable in 75% of patients, decreased in 4% of patients, and increased in 21% of patients. The pattern of increased stiffness measurements was associated with both HCV-RNA positive status and the presence of an active biliary complication of liver transplantation and was more predictive of a clinically significant event resulting from any disease of the transplanted liver when compared to a stable pattern or to a single liver stiffness measurement. The procedures that were consequently performed were often diagnostic for unexpected situations, both in HCV-RNA positive and HCV-RNA negative patients.
  
  
  CONCLUSIONS
  The pattern of longitudinally increased liver stiffness measurements efficiently supported clinical decisions for individualized management strategies. Repeated transient elastography in real-life clinical practice appears to have a practical role in monitoring liver transplanted patients.
authors.affiliation: Department of Medical and Surgical Oncology, Liver Unit, AORN S. Anna and S. Sebastiano, Caserta, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Rinaldi
authors.affiliation: Department of Medical and Surgical Oncology, Liver Unit, AORN S. Anna and S. Sebastiano, Caserta, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Valente
authors.affiliation: Department of Medical and Surgical Oncology, Liver Unit, AORN S. Anna and S. Sebastiano, Caserta, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Piai
keywords: Liver Biopsy; Liver Fibrosis; Liver Stiffness; Transient Elastography; Transplantation