Monitoring the Natural Evolution and Response to Treatment of Post Liver Transplant Recurrent Hepatitis C Using Transient Elastography: Preliminary Results

• Published in: Transplantation proceedings 2012-09, Vol.44 (7), p.2082-2086
• Main Authors: Bellido-Muñoz, F, Giráldez-Gallego, A, Roca-Oporto, C, García-Cayuela, T, Pascasio-Acevedo, J.M, Sousa-Martín, J.M
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Elasticity Imaging Techniques; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatitis C - physiopathology; Human viral diseases; Humans; Infectious diseases; Liver Transplantation; Male; Medical sciences; Middle Aged; Prospective Studies; Recurrence; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Viral diseases; Viral hepatitis
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.07.090

Abstract Objectives To perform a prospective analysis of changes in liver stiffness (LS) using transient elastography (TE) in a consecutive series of patients with post-liver transplant (LT) recurrent hepatitis C, either left to their natural evolution or receiving antiviral treatment. Methods We examined the results from 17 comparisons of TE (baseline vs follow-up) from 11 patients. We evaluated: (1) upon inclusion in the study: age, sex, genotype, time transpired since LT, and baseline fibrosis (F0-4; Scheuer), and (2) during the follow-up period: time elapsed between the two TE and either specific treatment (B) or absence of treatment (A). Results Mean patient age was 56.8 ± 7.9 years, with a male/female ratio of 10:1. Ten of the eleven patients had genotype 1b. The median time transpired between the LT and inclusion in the study was 28 months (range: 6–142 months). The mean time transpired between the two TE was 11.3 ± 4.5 months. In the 11 patients from group A (9 F1/2 F2; 13 “paired” TE), a predictable increase in LS was produced in 10 cases and a paradoxical result was produced in 3 cases. In the four patients in group B (3 F2/1 F1; 4 “paired” TE), a decrease in LS was produced in 3 cases and a paradoxical result in 1 case. Conclusions In our study of patients left to their natural evolution, a slow increase of LS was normal. However, antiviral treatment appeared to decrease LS. TE can be very useful as a complementary test to biopsy for monitoring post-LT recurrent hepatitis C. A longer follow-up period and larger sample size could confirm these preliminary results.