Acoustic Radiation Force Impulse Elastography in Post-transplant Recurrent Hepatitis C in Living Donor Liver Transplantation

• Published in: Transplantation proceedings Vol. 50; no. 9; pp. 2695 - 2698
• Main Authors: Huang, T.-L., Chen, T.-Y., Tsang, L.-C., Ou, H.-Y., Yu, C.-Y., Hsu, H.-W., Lim, W.-X., Cheng, Y.-F., Chen, C.-L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2018
• Subjects: Adult; Elasticity Imaging Techniques - methods; Female; Hepatitis C, Chronic - diagnostic imaging; Hepatitis C, Chronic - pathology; Humans; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver Transplantation; Living Donors; Male; Middle Aged; Recurrence
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.04.058

The aim of the study was to evaluate the efficacy of liver fibrosis (LF) with acoustic radiation force impulse (ARFI) elastography for post-transplant (post-LT) HCV recurrence. We enrolled 89 adult recipients of living donor liver transplantation (LDLT) who had HCV, with or without post-LT HCV recurrence and treated or not treated. The post-LT HCV recurrence was diagnosed on the basis of RNA viral load present. ARFI examination was performed every 3 months for all patients, with shear wave velocity (SWV) obtained quantitatively in m/s and correlated with histopathologic fibrosis scoring of liver biopsy (LB). There were 50 (50 of 89) patients without HCV recurrence and 39 (39 of 89) with post-LT recurrence in the 89 patients studied. The recurrent group had significantly higher median SWVs (1.87 ± 0.52 vs 1.37 ± 0.52 m/s, P < .0001), in which 18 (18 of 39) patients had antiviral drug treatment and obtained significant improvement with SWVs from 1.83 ± 0.49 to 1.68 ± 0.56 m/s, P = .043. The correlations of LF staging between ARFI elastography and Ishak histopathologic LF scores showed great significance, P = .045. The HCV RNA titer after antiviral treatment decreased from 3,831,750 to 0, P < .0001, but the RNA titer of nontreated patients remained high and the median SWV increased. The Ishak LF staging in the nontreated group progressed from stage 1 to 2, P = .012 and SWV increased from 1.69 ± 0.54 to 1.91 ± 0.66 m/s, P = .085 at 1-year follow-up. ARFI elastography has efficient quantitative LF monitoring correlated with histopathologic staging for post-LT HCV recurrence. It could be an alternative, noninvasive method for frequent LB in the disease follow-up. •ARFI elastography has quantitative SWV correlated with histopathologic staging.•ARFI is efficient for LF monitoring for post-LT HCV recurrence and around antiviral treatment.•It could be a good noninvasive alternative method for frequent LB in the disease follow-up.