FibroScan evaluation of liver fibrosis in liver transplantation

Abstract

Introduction: Liver biopsy remains the gold standard to evaluate fibrosis. However, it is invasive and uncomfortable as well as associated with complications. Transient elastography (FibroScan) is a simple and noninvasive method to assess liver fibrosis by measuring liver stiffness in kilopascals. Body mass index (BMI) greater than 28 is associated with high rates of invalid tests. Liver transplant patients show increased rates of obesity. We do not yet have many data about the usefulness of FibroScan in liver transplantation.

Aims: To analyze the applicability of FibroScan to assess fibrosis in liver transplantation and study the association between obesity and valid tests.

Material and methods: We prospectively assessed the performance of transient elastography in 29 liver transplant patients from February to May 2008. We prospectively studied the success rate, the elasticity (stiffness) in kilopascals, and the BMI.

Results: The BMI was greater than 30 kg/m(2) in four patients; 25 to 30 kg/m(2) in eight; and 17 had BMI < 25 kg/m(2). The overall success of FibroScan was 24/29 (82.7%). However, among patients with BMI > 30 kg/m(2), it was 2/4 (50%), whereas for BMI <25 kg/m(2) it climbed to 100%. The average duration of the procedure was 211.52 seconds for BMI <25 kg/m(2); 236 seconds for BMI between 25 and 30 kg/m(2); and 361 seconds in patients with a BMI > 30 kg/m(2)-differences that were statistically significant.

Conclusions: FibroScan seemed to be a promising approach to assess liver fibrosis.BMI is a limiting factor toward achieving a valid test; FibroScan had limited usefulness in obese patients.