Assessment of graft fibrosis by transient elastography in patients with recurrent hepatitis C after living donor liver transplantation
Assessment of graft fibrosis by transient elastography in patients with recurrent hepatitis C after living donor liver transplantation
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DOI：
10.1097/01.tp.0000297248.18483.16
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发表时间：
2008-01-15
期刊：
影响因子：
6.2
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Harada, Noboru;Soejima, Yuji;Maehara, Yoshihiko
背景瞬时弹性成像（FibroScan）是一种通过测量肝脏硬度来评估肝纤维化的简单无创方法，因此可以成为评估肝纤维化和避免肝活检的有前途的工具。我们前瞻性地评估了瞬时弹性成像在活体肝移植术后丙型肝炎病毒复发患者中的表现，并与替代血清标志物进行比较。五十六例活体肝移植术后丙型肝炎病毒复发的患者接受了肝活检和瞬时弹性成像检查。将活检获得的肝纤维化分级（Scheuer分级）与瞬时弹性成像测量的肝硬度进行比较。纤维化分级如下：F0，n=22; F1，n = 13; F2，n = 9; F3，n= 7;和F4，n= 5。肝硬度值范围为2.9 - 72.0 kPa。F >= 1时的最佳截止值为8.8 kPa，F > 2时为9.9 kPa，F >= 3时为15.4 kPa，F >= 4时为26.5 kPa。瞬时弹性成像诊断纤维化（F >= 2）的受试者操作特征曲线下面积为0.92，而透明质酸、4型胶原、丙氨酸氨基转移酶和天冬氨酸氨基转移酶与血小板比率指数分别为0.52、0.62、0.64和0.70。这些数据表明，瞬时弹性成像是一种简单，无创和可靠的工具，以评估肝纤维化的复发性丙型肝炎病毒患者活体肝移植后。
Background. Transient elastography (FibroScan) is a simple and noninvasive method to assess liver fibrosis by measuring liver stiffness and therefore can be a promising tool to evaluate liver fibrosis and avoid liver biopsy. We prospectively assessed the performance of transient elastography in patients with recurrent hepatitis C virus after living donor liver transplantation, in comparison with the surrogate serum markers.Methods. Fifty-six patients with recurrent hepatitis C virus after living donor liver transplantation, who under-went both liver biopsy and transient elastography were included in this study. The grade of liver fibrosis (the Scheuer classification) obtained by biopsy was compared to liver stiffness m easured by the transient elastography.Results. The fibrosis grades were as follows: F0, n=22; F1, n = 13; F2, n = 9; F3, n= 7; and F4, n= 5. Liver stiffness values ranged from 2.9 to 72.0 kPa. The optimal cutoff values were 8.8 kPa for F >= 1, 9.9 kPa for F > 2, 15.4 kPa for F >= 3, and 26.5 kPa for F >= 4. The area under the receiver operator characteristic curve for the diagnosis of fibrosis (F >= 2) by transient elastography was 0.92, while that by hyaluronic acid, type 4 collagen, alanine aminotransferase, and the aspartate transaminase to platelets ratio index were 0.52, 0.62, 0.64, and 0.70, respectively.Conclusions. These data suggest that transient elastography is a simple, noninvasive and reliable tool to assess liver fibrosis in patients with recurrent hepatitis C virus after living donor liver transplantation.