BACKGROUND AND AIM: Accurate quantification of progressive liver disease is essential for therapeutic decisions and follow-up for patients who underwent liver transplantation. To evaluate the quality of noninvasive assessment of liver fibrosis in these patients, we compared Doppler ultrasound of the hepatic blood vessels as well as transient elastography (TE, FibroScan(®)) with liver biopsy following transplantation. METHODS: We performed Doppler ultrasound of the hepatic veins, hepatic artery, and portal vein as well as a TE in 48 patients who underwent liver transplantation 12 months ago. Hepatic venous flow was evaluated by determination of the resistance index (HVRI) of the right hepatic vein. Doppler and TE results were compared with histopathologic workup of a 12-month protocol liver biopsy after transplantation. RESULTS: HVRI showed a high reliability in predicting liver fibrosis stage FII or higher (AUROC of 0.99 ± 0.001 for FII or higher, the HVRI < 1.05 with a sensitivity and specificity of 100 and 91.43 %) compared to histopathologic workup (Desmet's score) and was comparable to TE analysis. Both HVRI and TE differed significantly in no or minimal fibrosis versus FII or higher (p < 0.001). In contrast, portal vein and hepatic artery did not show significant changes in blood flow in our study population. CONCLUSIONS: Hepatic vein flow resistance index is a valuable tool in noninvasive evaluation of liver fibrosis in liver transplantation follow-up predicting FII or higher and might help reducing the number of protocol biopsies needed.
BACKGROUND AND AIM: Accurate quantification of progressive liver disease is essential for therapeutic decisions and follow-up for patients who underwent liver transplantation. To evaluate the quality of noninvasive assessment of liver fibrosis in these patients, we compared Doppler ultrasound of the hepatic blood vessels as well as transient elastography (TE, FibroScan(®)) with liver biopsy following transplantation. METHODS: We performed Doppler ultrasound of the hepatic veins, hepatic artery, and portal vein as well as a TE in 48 patients who underwent liver transplantation 12 months ago. Hepatic venous flow was evaluated by determination of the resistance index (HVRI) of the right hepatic vein. Doppler and TE results were compared with histopathologic workup of a 12-month protocol liver biopsy after transplantation. RESULTS: HVRI showed a high reliability in predicting liver fibrosis stage FII or higher (AUROC of 0.99 ± 0.001 for FII or higher, the HVRI < 1.05 with a sensitivity and specificity of 100 and 91.43 %) compared to histopathologic workup (Desmet's score) and was comparable to TE analysis. Both HVRI and TE differed significantly in no or minimal fibrosis versus FII or higher (p < 0.001). In contrast, portal vein and hepatic artery did not show significant changes in blood flow in our study population. CONCLUSIONS: Hepatic vein flow resistance index is a valuable tool in noninvasive evaluation of liver fibrosis in liver transplantation follow-up predicting FII or higher and might help reducing the number of protocol biopsies needed.
Authors: Anthony J Demetris; Oyedele Adeyi; Chris O C Bellamy; Andrew Clouston; Frederic Charlotte; Albert Czaja; Ierachmiel Daskal; Magda S El-Monayeri; Paulo Fontes; John Fung; Bruno Gridelli; Maria Guido; Hironori Haga; John Hart; Eva Honsova; Stefan Hubscher; Tomoo Itoh; Nirag Jhala; Patricia Jungmann; Urmila Khettry; Charles Lassman; Saverio Ligato; John G Lunz; Amadeo Marcos; Marta Ida Minervini; Johan Mölne; Mike Nalesnik; Imad Nasser; Desley Neil; Erin Ochoa; Orit Pappo; Parmjeet Randhawa; Finn P Reinholt; Phil Ruiz; Mylène Sebagh; Marco Spada; Aurelio Sonzogni; Athanassios C Tsamandas; Annika Wernerson; Tong Wu; Funda Yilmaz Journal: Hepatology Date: 2006-08 Impact factor: 17.425
Authors: G Crespo; S Lens; M Gambato; J A Carrión; Z Mariño; M-C Londoño; R Miquel; J Bosch; M Navasa; X Forns Journal: Am J Transplant Date: 2014-01-10 Impact factor: 8.086
Authors: Moon Young Kim; Soon Koo Baik; Dong Hun Park; Dae Wook Lim; Jae Woo Kim; Hyun Soo Kim; Sang Ok Kwon; Young Ju Kim; Sei Jin Chang; Samuel S Lee Journal: Liver Int Date: 2007-10 Impact factor: 5.828
Authors: Eric J Siskind; Fauzia Vandermeer; Tamar R Siskind; David A Bruno; Samuel Sultan; Josue Alvarez-Casas; Arielle Stafford; Barton Lane; John C Lamattina; Rolf N Barth; Steven I Hanish Journal: Int J Angiol Date: 2017-03-01
Authors: Roberta Angelico; Bruno Sensi; Tommaso M Manzia; Giuseppe Tisone; Giuseppe Grassi; Alessandro Signorello; Martina Milana; Ilaria Lenci; Leonardo Baiocchi Journal: World J Gastroenterol Date: 2021-12-07 Impact factor: 5.742