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HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST

BACKGROUND: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. AIM: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and withou...

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Autores principales: NACIF, Lucas Souto, PARANAGUA-VEZOZZO, Denise C, MATSUDA, Alina, ALVES, Venancio Avancini Ferreira, CARRILHO, Flair J, FARIAS, Alberto Queiroz, D’ALBUQUERQUE, Luiz Carneiro, ANDRAUS, Wellington
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Colégio Brasileiro de Cirurgia Digestiva 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050003/
https://www.ncbi.nlm.nih.gov/pubmed/29947694
http://dx.doi.org/10.1590/0102-672020180001e1360
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author NACIF, Lucas Souto
PARANAGUA-VEZOZZO, Denise C
MATSUDA, Alina
ALVES, Venancio Avancini Ferreira
CARRILHO, Flair J
FARIAS, Alberto Queiroz
D’ALBUQUERQUE, Luiz Carneiro
ANDRAUS, Wellington
author_facet NACIF, Lucas Souto
PARANAGUA-VEZOZZO, Denise C
MATSUDA, Alina
ALVES, Venancio Avancini Ferreira
CARRILHO, Flair J
FARIAS, Alberto Queiroz
D’ALBUQUERQUE, Luiz Carneiro
ANDRAUS, Wellington
author_sort NACIF, Lucas Souto
collection PubMed
description BACKGROUND: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. AIM: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. METHOD: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. RESULTS: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7±6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73±22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65±22.2 kPa vs. 50.87±20.9 kPa (p=0.098) and higher MELD scores (p=0.035). CONCLUSION: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality.
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spelling pubmed-60500032018-07-18 HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST NACIF, Lucas Souto PARANAGUA-VEZOZZO, Denise C MATSUDA, Alina ALVES, Venancio Avancini Ferreira CARRILHO, Flair J FARIAS, Alberto Queiroz D’ALBUQUERQUE, Luiz Carneiro ANDRAUS, Wellington Arq Bras Cir Dig Original Article BACKGROUND: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. AIM: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. METHOD: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. RESULTS: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7±6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73±22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65±22.2 kPa vs. 50.87±20.9 kPa (p=0.098) and higher MELD scores (p=0.035). CONCLUSION: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality. Colégio Brasileiro de Cirurgia Digestiva 2018-06-21 /pmc/articles/PMC6050003/ /pubmed/29947694 http://dx.doi.org/10.1590/0102-672020180001e1360 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
NACIF, Lucas Souto
PARANAGUA-VEZOZZO, Denise C
MATSUDA, Alina
ALVES, Venancio Avancini Ferreira
CARRILHO, Flair J
FARIAS, Alberto Queiroz
D’ALBUQUERQUE, Luiz Carneiro
ANDRAUS, Wellington
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title_full HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title_fullStr HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title_full_unstemmed HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title_short HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
title_sort higher values in liver elastography and meld score are mortality predictors on liver transplant waiting list
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6050003/
https://www.ncbi.nlm.nih.gov/pubmed/29947694
http://dx.doi.org/10.1590/0102-672020180001e1360
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