Spleen transient elastography predicts actuarial survival after liver transplantation

Kilian Friedrich; Arianeb Mehrabi; Jan Pfeiffenberger; Christian Rupp; Karl Heinz Weiss; Markus Mieth

doi:10.21037/tgh-19-343

Spleen transient elastography predicts actuarial survival after liver transplantation

Transl Gastroenterol Hepatol. 2022 Jul 25:7:31. doi: 10.21037/tgh-19-343. eCollection 2022.

Authors

Kilian Friedrich¹, Arianeb Mehrabi², Jan Pfeiffenberger¹, Christian Rupp¹, Karl Heinz Weiss¹, Markus Mieth²

Affiliations

¹ Department of Gastroenterology and Hepatology, University Hospital of Heidelberg, Heidelberg, Germany.
² Department of General, Visceral and Transplantation Surgery, University Hospital of Heidelberg, Heidelberg, Germany.

Abstract

Background: Splenic transient elastography (TE) correlates with increased portal pressure. Little data are available in the post liver transplantation (LTx) setting.

Methods: Three months after LTx, we performed splenic TE in 125 LTx recipients.

Results: Mean splenic TE values were 29.4 (±6.3; range, 21.6-49.2) kPa. Splenic TE correlated with reduced time to development until persistent ascites (30 events, OR =1.082, 95% CI: 1.034-1.133; P=0.001), hepatorenal syndrome (8 events, OR =1.109, 95% CI: 1.015-1.211; P=0.022) and hepatic encephalopathy (16 events, OR =1.136, 95% CI: 1.066-1.211; P=0.000). In Cox univariate analysis, splenic TE served as a predictor of actuarial survival free of liver (OR =1.114, 95% CI: 1.050-1.182; P<0.001) and remained an independent risk factor associated with reduced actuarial survival free of LTx in multivariate analysis (OR =1.103, 95% CI: 1.026-1.186; P=0.008).

Conclusions: Splenic TE measurement at 3 months after LTx serves as a robust predictor of survival in LTx recipients.

Keywords: Spleen; liver transplantation (LTx); survival; transient elastography (TE).