Determination of allograft fibrosis by measurement of liver stiffness using transient elastography in children after liver transplantation at Shiraz Organ Transplant Center

AIM: The aim of this study was to determine allograft fibrosis by measuring LS using TE in children after liver transplantation at Shiraz Organ Transplant Center. BACKGROUND: Liver stiffness (LS) assessment using fibro-scanning (transient elastography-TE) is a non-invasive method for evaluating liver fibrosis. METHODS: All children undergoing liver transplant from 2012 to 2016 were included in the study. Data on demographics, graft types, immunosuppressive drugs, as well as clinical and paraclinical data were obtained from patients’ records. TE was performed to determine LS in all patients. Liver fibrosis was also confirmed based on Metavir score. RESULTS: During this period, more than 400 liver Tx were done in children, but only 54 patients, comprising 20 (37%) girls and 34 (63%) boys who underwent liver transplantation, were available and willing to participate in this study. The mean age of the patients was 12.96 ± 5.32 years. Correlations between FS score (LS) and AST (p = 0.01), total bilirubin (p = 0.002), albumin (p = 0.001), PT (p = 0.03), and INR (p = 0.001) were significant. There was no significant relationship between FS score (LS) and type of allograft (p = 0.79) and underlying disease (p = 0.36). Positive and significant correlations were observed between Metavir score and AST (p = 0.01), total bilirubin (p = 0.01), INR (p = 0.004), and cholesterol (p = 0.001). The severity of fibrosis significantly and negatively correlated with albumin (p = 0.004) and glucose (p = 0.003). Also, there was no significant relationship between Metavir score and allograft type (p = 0.7). CONCLUSION: The current study demonstrated that 14.9% of LT patients had a METAVIR ≥ F2. The time between LT and TE was significantly correlated with LS and the degree of liver fibrosis based on Metavir score. However, there was no significant relationship between LS with allograft type or underlying liver disease.