Routine Liver Elastography Could Predict Actuarial Survival after Liver Transplantation

J Gastrointestin Liver Dis. 2019 Sep 12;28(3):271-277. doi: 10.15403/jgld-218.

Abstract

Background and aims: Transient elastography (TE) has routinely been implemented in the diagnosis and assessment of chronic liver disease. Little data are available in the post liver transplant (LTx) setting.

Methods: Three months after LTx, we performed TE in 137 liver transplant recipients and investigated its predictive value upon further clinical outcome. The mean follow-up time for clinical outcome was 24 months.

Results: Mean TE value was 10.6 kPa (± 6.3 kPa; range 2.8 - 29.9 kPa). There was a significant correlation between TE and aspartate aminotransferase (AST) (p=0.004), gamma-glutamyl transferase (GGT) (p=0.031) and bilirubin (p<0.001) serum levels. In Cox univariate analysis, TE served as a predictor of actuarial survival free of liver transplantation (OR=1.111, 95%CI: 1.051-1.174; p<0.001). In multivariate analysis, TE remained an independent risk factor associated with reduced actuarial survival free of liver transplantation (OR=1.080, 95%CI: 1.001-1.166; p=0.047), along with thrombocytes (OR=0.992, 95%CI: 0.986-0.999; p=0.020) and metabolic co-disease (OR = 0.250, 95%CI: 0.070-0.895; p=0.033).

Conclusion: Transient elastography measurement at three months after LTx seems a robust predictor of survival in liver transplant recipients.

MeSH terms

  • Adult
  • Aged
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Biomarkers / blood
  • Biopsy
  • Elasticity Imaging Techniques / methods*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / pathology
  • Liver Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Postoperative Care / methods
  • Postoperative Complications / diagnostic imaging
  • Postoperative Period
  • Predictive Value of Tests
  • Prognosis
  • Recurrence
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Bilirubin