Elsevier

Transplantation Proceedings

Volume 51, Issue 7, September 2019, Pages 2446-2450
Transplantation Proceedings

First International Transplant Network Congress
Liver Transplantation
Liver Graft and Spleen Elastography After Living Liver Transplantation: Our First Results

https://doi.org/10.1016/j.transproceed.2019.01.184Get rights and content

Abstract

Aim of the study

Liver transplantation is widely applied as a standard and effective management of end-stage liver diseases, hepatocellular carcinoma, and acute liver failure. Investigation of morphologic and functional changes in the transplanted graft, gastrointestinal system, and spleen after transplantation is an important ground for assessment of post-transplantation results, early changes related to complications, and evaluation of response to treatment modalities. The aim of this study was to investigate the dynamics of changes in elastography of the liver graft and spleen after living-related liver transplantation.

Material and methods

The study included 14 cirrhotic patients after living-related liver graft transplantation. Stiffness of the spleen and liver was evaluated before transplantation and at 1, 3, and 6 months after transplantation with a Supersonic Aixplorer Multi Wave device. Each procedure consisted of measuring the density in 10 points (spots) of the organ. The final result was calculated as the mean value of successful measurements (must have been > 60% of all measurements) and expressed in kilopascals.

Results

The mean value of the liver and spleen stiffness before transplantation was 27 kPa (14–31 kPa) and 51 kPa (38–92 kPa), respectively. The stiffness of the spleen gradually reduced after transplantation to 40.3, 35.4, and 24.1 kPa (P = .001) at 1, 3, and 6 months. The stiffness of the liver graft in patients without complications was stable at 4–5 kPa, whereas the same value in patients with complications was increased (≥ 7.5 kPa). In 5 patients, endoscopic investigation confirmed the significant reduction of varicose veins after surgery.

Conclusion

Elastography of the liver graft and spleen after liver transplantation can be recommended as a useful-for-patient 1-off method of investigation.

Section snippets

Patients

Fourteen patients underwent living-related liver transplantation in Custom’s Hospital and Liver Transplantation Institute of Inonu University with further follow-up in Azerbaijan Medical University from 2015 through 2018. The patients included in this study had a preoperative elastography, had a living-related right lobe liver transplantation, and survived for at least 6 months after surgery. Patients with retransplantation, splenectomy, or ligation of the splenic artery were not included in

Description of Patients

The results of 14 patients with living-related right-lobe liver transplantation and elastography before surgery and at 1, 3, and 6 months after surgery were carefully analyzed. General information on patients is presented in Table 1. The mean age of patients was 51 years (21–65 years), and there were 9 men and 5 women. Indications for transplantation were cirrhosis with hepatitis B virus genesis in 2 patients, hepatitis C virus genesis in 3 patients, congenital genesis in 3 patients, metabolic

Discussion

There have been 2 major results of our study regarding changes in elastography of the spleen and liver before surgery and at 1, 3, and 6 months after surgery in patients with living-related liver transplantation. First, we found out that the stiffness of the spleen was high before surgery and gradually reduced after surgery, being close to the normal rates at the sixth month; and these changes had no relationship to complications. Second, we revealed that liver stiffness was normal and stable

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    • This study has been carried out with the support of the Science Development Foundation, under the President of the Republic of Azerbaijan.

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