Assessment of liver fibrosis in transplant recipients with recurrent HCV infection: Usefulness of transient elastography

Corradi, Francesco; Piscaglia, Fabio; Flori, S.; D’Errico-Grigioni, A.; Vasuri, Francesco; Tamé, Mariarosa; Andreone, Pietro; Boni, P; Gianstefani, Alice; Bolondi, Luigi

doi:10.1016/j.dld.2008.06.009

Cited by 78 publications

(88 citation statements)

References 37 publications

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“…However, liver stiffness measurement (LSM) cannot yet confidently predict the presence of esophageal varices in clinical practice and thus avoid the need for upper GI endoscopic screening of cirrhotic patients [85]. TE could be also valuable for assessing the severity of recurrent hepatitis C after liver transplantation, reducing the need for follow-up liver biopsies [78,[86][87][88][89][90]. It has been recently suggested that TE may perform better for significant fibrosis than serum (direct and indirect) biomarkers [91].…”

Section: Monitoring Of Disease Progressionmentioning

confidence: 99%

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Castéra

2011

Hepatol Int

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Section: Monitoring Of Disease Progressionmentioning

confidence: 99%

Non-invasive assessment of liver fibrosis in chronic hepatitis C

Castéra

2011

Hepatol Int

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“…8 Corradi and associates evaluated APRI in HCV liver transplant patients and found significant fibrosis, which correlated with a good AUC of 0.815. 20 Most of the available studies were done in patients who had HCV as an indication for liver transplant and focused on identifying significant fibrosis as opposed to advanced fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Kabbany

Selvakumar²,

Guirguis³

et al. 2018

Exp Clin Transplant

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Objectives: Several scoring systems have been developed to noninvasively predict the presence of advanced fibrosis in patients with chronic liver disease. Hepatitis C virus and nonalcoholic fatty liver disease are the 2 most common indications for orthotopic liver transplant and are associated with disease recurrence that can lead to fibrosis progression. Here, we evaluated the performance of commonly used fibrosis scores in assessing the presence of advanced fibrosis in patients after orthotopic liver transplant. Materials and Methods: Our study consisted of consecutive patients with hepatitis C virus or nonalcoholic fatty liver disease who underwent a liver biopsy after transplant and had laboratory measurements within 1 week of biopsy. Graft fibrosis was determined by an experienced pathologist (stage F0-F4). Advanced fibrosis was defined as stage F3-F4. The following fibrosis scores were calculated for each patient: aspartate aminotransferase/alanine aminotransferase ratio, aspartate aminotransferase/platelet ratio index, and fibrosis-4 index. Results: We analyzed 93 patients with median age of 59 years (25th and 75th percentile of 53 and 64 y) and median body mass index of 31.8 kg/m 2 (25th and 75th percentile of 27 and 37.6 kg/m 2 ). Of total patients, 41 (44%) were diabetic. Median time to liver biopsy posttransplant was 27.7 months (25th and 75 percentile of 10.8 and 59.9 mo). We found that 54 patients (58%) had no fibrosis, 15 (16.1%) had F1, 8 (8.6%) had F2, 7 (7.5%) had F3, and 9 (9.7%) had F4. Overall, advanced fibrosis (F3-F4) was present in 16 patients. Aspartate aminotransferase/alanine aminotransferase ratio, aspartate aminotransferase/platelet ratio index, and fibrosis-4 index were not significantly different between patients with and without advanced fibrosis (all P > .05). The calculated fibrosis scores had poor diagnostic accuracy for presence of advanced fibrosis posttransplant. Conclusions: Commonly used liver fibrosis scores are not accurate in predicting the presence of advanced fibrosis in patients after liver transplant.

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“…Transient elastography, already shown to be a very valid technique in this setting, 3,6,7 appears to perform better at identifying significant liver fibrosis than indexes derived from laboratory variables.…”

mentioning

confidence: 92%

“…This would help us to avoid some biopsy procedures, monitor fibrosis progression more strictly during posttransplant follow-up, and better predict graft prognosis and the right time for starting antiviral therapies. A prospective validation of a noninvasive index based on laboratory data [the Hospital Universitario La Fe (HULF) index] failed to reproduce the high accuracy in identifying significant fibrosis found in the initial retrospective analysis from which the HULF index was initially developed [the area under the receiver operating characteristic curve (AUROC) was 0.68 in the new validation study 1 3 Recently, an English collaborative group proposed a new noninvasive index based on laboratory variables, the London Transplant Centres (LTC) score, that easily estimates the presence of significant fibrosis in patients with recurrent HCV infections. 4 This index was derived retrospectively from their patient series and provided an AUROC of 0.86 for METAVIR fibrosis F2.…”

mentioning

confidence: 99%