Diagnostic performance of non-invasive tests for evaluation of hepatic graft fibrosis in pediatric liver transplantation: A scoping review

Diagnostic performance of 2D‐shear wave elastography and serum fibrosis markers for evaluation of hepatic graft fibrosis in pediatric liver‐inclusive transplant recipients: A prospective pilot study

“…Among the examined biomarkers, APRI was the most commonly used marker but has shown a heterogenous diagnostic performance and a wide range of cut-offs in predicting significant hepatic graft fibrosis. 12,23,24,27,28 In contrast with previous studies that reported a fair AUROC (0.74) for APRI to predict significant hepatic graft fibrosis, 24,27 the present study has shown a good AUROC (0.85) and that the optimal APRI cut-off value of 1.83 yielded a sensitivity of 100% and a specificity of 67% to predict significant hepatic graft fibrosis. The AST/ALT ratio was investigated in only one pediatric study that showed a poor AUROC of 0.69 for predicting significant hepatic graft fibrosis.…”

“…The advantage of using these biomarkers is that serum transaminases and platelet count are part of routine laboratory evaluation with no additional cost. Among the examined biomarkers, APRI was the most commonly used marker but has shown a heterogenous diagnostic performance and a wide range of cut‐offs in predicting significant hepatic graft fibrosis 12,23,24,27,28 . In contrast with previous studies that reported a fair AUROC (0.74) for APRI to predict significant hepatic graft fibrosis, 24,27 the present study has shown a good AUROC (0.85) and that the optimal APRI cut‐off value of 1.83 yielded a sensitivity of 100% and a specificity of 67% to predict significant hepatic graft fibrosis.…”

“…study has previously investigated the diagnostic performance of 2D-SWE in the pediatric LT setting. 23 The advantage of 2D-SWE over TE is that it is integrated into a conventional ultrasound system and…”

“…Because of the known limitations of liver biopsy, 4‐9 there has been an increasing interest in noninvasive tests, such as serum‐based fibrosis markers and elastography, to assess and monitor the progression of hepatic fibrosis in both nontransplant and LT settings. Despite a limited number of studies investigating the usefulness of noninvasive tests to assess hepatic graft fibrosis in the pediatric LT population, our recent scoping review demonstrated that TE remains the most widely used elastography technique in LT children, and no study has previously investigated the diagnostic performance of 2D‐SWE in the pediatric LT setting 23 …”

Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy

“…Small longitudinal studies have shown that intensification of immunosuppression after histological diagnosis of inflammation and fibrosis leads to a reduction in fibrosis scores [ 80 , 84 ]. To date, studies investigating noninvasive techniques for identifying liver fibrosis in post-LT settings found that VCTE was superior to acoustic radiation force impulse (ARFI) and serum biomarkers (e.g., AST/alanine transaminase [ALT] ratio, APRI, FibroTest [FT], and enhanced liver fibrosis test) [ 85 ].…”