TY - JOUR
T1 - Comparison of acoustic radiation force impulse/serum noninvasive markers for fibrosis prediction in liver transplant
AU - Pinto, Joana
AU - Matos, Hugo
AU - Nobre, Susana
AU - Cipriano, Maria A.
AU - Marques, Margarida
AU - Pereira, João M.S.
AU - Gonçalves, Isabel
AU - Noruegas, Maria J.
PY - 2014/3
Y1 - 2014/3
N2 - Objectives: Fibrosis, related to several causes, can be diagnosed in children and adolescents’ liver grafts that are >1 year old. At present, liver biopsy is the gold standard for assessing liver damage in the posttransplant setting. We aimed to evaluate the accuracy of noninvasive biomarkers of fibrosis, namely, acoustic radiation force impulse (ARFI), aspartate-to-platelet ratio index, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio index, either alone or in combination, for predicting fibrosis in pediatric patients submitted to liver transplantation. Methods: We prospectively assessed liver fibrosis in 30 children/adolescents with liver transplant through biopsy (liver transplant follow-up during 12 months). ARFI with Virtual Touch Software (Acuson 2000) was performed, and blood samples were taken to determine liver function and platelet count. Two groups were analyzed according to the histopathologic stage of fibrosis, namely, none/mild (F0–F1) versus significant fibrosis (F2-4).Results: The mean age of the 30 patients was 11 years (3–18 years), with a mean posttransplant period of assessment of 6.5 years. Twenty-four patients (80%) presented stage F0–F1 fibrosis and 6 patients (20%) presented stage F2-4. The area under the curve using receiver operating characteristic analysis for ARFI, aspartate-to-platelet ratio index, and AST/ALT ratio index for significant fibrosis was 0.76 (P = 0.052), 0.74 (P = 0.066), and 0.69 (P = 0.162), respectively. Through multivariate logistic regression analysis, the only independent predictor of significant fibrosis was ARFI (odds ratio 10.7, 95% confidence interval 1.2–95.7; P = 0.045). The combination of ARFI and AST/ALT ratio index presented a good diagnostic accuracy of fibrosis (area under the curve of 0.83; P = 0.013).Conclusions: ARFI may serve as a potential method for assessing significant fibrosis in pediatric patients with liver transplant, particularly in combination with AST/ALT ratio index.
AB - Objectives: Fibrosis, related to several causes, can be diagnosed in children and adolescents’ liver grafts that are >1 year old. At present, liver biopsy is the gold standard for assessing liver damage in the posttransplant setting. We aimed to evaluate the accuracy of noninvasive biomarkers of fibrosis, namely, acoustic radiation force impulse (ARFI), aspartate-to-platelet ratio index, and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio index, either alone or in combination, for predicting fibrosis in pediatric patients submitted to liver transplantation. Methods: We prospectively assessed liver fibrosis in 30 children/adolescents with liver transplant through biopsy (liver transplant follow-up during 12 months). ARFI with Virtual Touch Software (Acuson 2000) was performed, and blood samples were taken to determine liver function and platelet count. Two groups were analyzed according to the histopathologic stage of fibrosis, namely, none/mild (F0–F1) versus significant fibrosis (F2-4).Results: The mean age of the 30 patients was 11 years (3–18 years), with a mean posttransplant period of assessment of 6.5 years. Twenty-four patients (80%) presented stage F0–F1 fibrosis and 6 patients (20%) presented stage F2-4. The area under the curve using receiver operating characteristic analysis for ARFI, aspartate-to-platelet ratio index, and AST/ALT ratio index for significant fibrosis was 0.76 (P = 0.052), 0.74 (P = 0.066), and 0.69 (P = 0.162), respectively. Through multivariate logistic regression analysis, the only independent predictor of significant fibrosis was ARFI (odds ratio 10.7, 95% confidence interval 1.2–95.7; P = 0.045). The combination of ARFI and AST/ALT ratio index presented a good diagnostic accuracy of fibrosis (area under the curve of 0.83; P = 0.013).Conclusions: ARFI may serve as a potential method for assessing significant fibrosis in pediatric patients with liver transplant, particularly in combination with AST/ALT ratio index.
KW - Acoustic radiation force impulse
KW - Aspartate aminotransferase/alanine aminotransferase index
KW - Aspartate-to-platelet ratio index
KW - Noninvasive diagnosis of liver fibrosis
KW - Pediatric liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=84896710127&partnerID=8YFLogxK
U2 - 10.1097/mpg.0000000000000226
DO - 10.1097/mpg.0000000000000226
M3 - Article
C2 - 24164902
AN - SCOPUS:84896710127
SN - 0277-2116
VL - 58
SP - 382
EP - 386
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 3
ER -