Non-Invasive Assessment of Graft Fibrosis After Living Donor Liver Transplantation: Is There Still a Role for Liver Biopsy?
| Autor: | Nadia Abdelaaty Abdelkader, Mohamed A. Sakr, M. Aly, Mahmoud El-Meteini, R. Refaie, Hany Dabbous, Z. Mohran, M. Salah, Iman F. Montasser, Ahmed Eldorry |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Hepatitis C virus Biopsy Aspartate transaminase medicine.disease_cause Gastroenterology Sensitivity and Specificity Fibrosis Internal medicine Living Donors Medicine Humans Aspartate Aminotransferases Transplantation biology medicine.diagnostic_test business.industry Area under the curve Middle Aged medicine.disease Magnetic resonance elastography Liver Transplantation ROC Curve Liver biopsy biology.protein Elasticity Imaging Techniques Surgery Female business Transient elastography |
| Zdroj: | Transplantation proceedings. 51(7) |
| ISSN: | 1873-2623 |
| Popis: | Non-invasive methods have evolved as a surrogate for liver biopsy such as indirect markers (aspartate transaminase to platelet ratio index, fibro-α score), transient elastography (TE), and magnetic resonance elastography (MRE). The aim of this study is to prospectively compare the value of MRE, TE, and indirect markers in detecting and staging allograft fibrosis compared to liver biopsies in patients who have undergone living donor liver transplantation for complications related to hepatitis C virus. A total of 31 living donor liver transplantation recipients with hepatitis C virus recurrence underwent a liver biopsy, TE, and MRE within 3 months of a liver biopsy. Fibrosis was assessed according to the biopsy and staged according to Metavir criteria. There was a significant correlation between both MRE and fibro-α scores, as well as histologic classification by liver biopsy (P = .02, .002). The diagnostic accuracy of MRE and fibro-α scores in diagnosing significant fibrosis (F ≥ 3) was measured as the area under the curve (.708 and .833, respectively). Both methods showed good diagnostic performance. TE and aspartate transaminase to platelet ratio index were insignificantly correlated with the degree of fibrosis in liver biopsy (P value of .134, .535). At a cutoff value of 5.5 kPa, MRE predicted graft fibrosis (Metavir stage ≥ 3) with 71.43% sensitivity, 75% specificity, 45.5% positive predictive value, and 90% negative predictive value; at a cutoff value > 1.47, fibro-α scores predicted significant graft fibrosis (Metavir stage ≥ 3) with 85.7% sensitivity and 70.83% specificity, with a positive predictive value of 46.2% and a negative predictive value of 94.4%. These data suggest that non-invasive methods could be considered a reliable tool in assessing significant graft fibrosis post-living donor liver transplantation. |
| Databáze: | OpenAIRE |
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