Association of shear-wave elastography with clinical outcomes post-liver transplantation

Purpose: Two-dimensional shear-wave elastography (2D-SWE) assessment of liver stiffness has the advantage of being obtained during conventional ultrasound. Liver-stiffness values on 2DSWE for grafted livers are unknown, as are their potential link to post-transplantation morbidity. This study was undertaken to determine liver-stiffness values on 2D-SWE for grafted livers without complications, and examine relationships between liver-stiffness values on 2D-SWE and early post-operative arterial or biliary complications. Methods: In our facility, all liver-transplant recipients are entered in a comprehensive surgical database, where donor, procedure and recipient characteristics are described. All patients underwent systematic 2D-SWE assessment. Potential relationships were analyzed between liver stiffness findings and donor, procedure and recipient characteristics, and follow-up events, including death, arterial or biliary complications, graft removal and allograft-dysfunction scores. Results: Liver-stiffness values on 2D-SWE of 337 ultrasound examinations from 165 liver -transplant recipients were collected retrospectively. Median time from transplantation to 2D-SWE examination was 149 days, with median follow-up at 36 months. The mean +/- SD stiff-ness value for grafts without complications was 7.3 +/- 2.3 kPa; it was significantly higher during the first 90 days (8.2 +/- 2.5 kPa) post-transplant than after 1 year (7.0 +/- 2.4 kPa) (P = 0.01). Patients with biliary complications during the first-year post-transplantation had significan-tly higher mean liver-stiffness values on 2D-SWE than those without, respectively: 9.8 +/- 7.0 vs 7.5 +/- 1.8kPa (P = 0.01). Conclusions: Post-transplantation patients without complications had stiffer livers than the general population, with higher values during the first 90 days after surgery. Liver-stiffness val-ues on 2D-SWE were significantly higher for patients with biliary, but not arterial, complications. (c) 2020 Elsevier Masson SAS. All rights reserved.

Automated summary

In this study, liver-stiffness values on 2D-SWE were found to be significantly higher in liver transplant patients without complications during the first 90 days post-transplantation compared to after 1 year. Patients with biliary complications had significantly higher liver-stiffness values on 2D-SWE compared to those without complications.