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The use of transient elastography and non-invasive serum markers of fibrosis in pediatric liver transplant recipients.
Goldschmidt, Imeke; Stieghorst, Henrik; Munteanu, Mona; Poynard, Thierry; Schlue, Jerome; Streckenbach, Carolin; Baumann, Ulrich.
Afiliação
  • Goldschmidt I; Pediatric Gastroenterology and Hepatology, Department for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany. goldschmidt.imeke@mh-hannover.de
Pediatr Transplant ; 17(6): 525-34, 2013 Sep.
Article em En | MEDLINE | ID: mdl-23802661
The use of non-invasive markers to diagnose liver allograft fibrosis is not well established in children after LTx. TE, FT, and ELF score were performed in 117 liver-transplanted children (60M, 8.9 [0.5-18.5] yr) and 336 healthy controls. Liver biopsy was available in 36 children. Results of histology and non-invasive markers were compared using correlation coefficient or Mann-Whitney U-test as appropriate. TE correlated best with histological degree of fibrosis (r = 0.85 vs. r = 0.04 [FT] or r = -0.38 [ELF]). Liver stiffness values for transplanted children without fibrosis were significantly higher than those of healthy controls (7.55 [5.4-20.4] kPa vs. 4.5 [2.5-8.9] kPa). Presence of rejection was a potent confounder for the performance of TE. Both TE and FT reflected clinical changes (acute rejection, cholestasis, increasing fibrosis) in a total of 16 patients who underwent serial measurements. TE correlates better with histological degree of fibrosis in liver-transplanted children than FT or ELF, but an individual baseline value needs to be determined for each patient. Normal or cutoff values for pathological degrees of fibrosis cannot be transferred from non-transplanted children. Follow-up studies, preferably with protocol biopsies, might help to improve the diagnostic quality of TE.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Fígado / Falência Hepática / Técnicas de Imagem por Elasticidade / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2013 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Fígado / Falência Hepática / Técnicas de Imagem por Elasticidade / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Ano de publicação: 2013 Tipo de documento: Article