Marticorena Garcia Stephan R, Althoff Christian E, Dürr Michael, Halleck Fabian, Budde Klemens, Grittner Ulrike, Burkhardt Christian, Jöhrens Korinna, Braun Jürgen, Fischer Thomas, Hamm Bernd, Sack Ingolf, Guo Jing
Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany.
J Clin Med. 2021 Feb 1;10(3):510. doi: 10.3390/jcm10030510.
Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of this study was to longitudinally evaluate viscoelasticity changes in the liver and in kidney allografts in kidney transplant recipients (KTRs) with HCV infection after treatment with direct-acting antiviral agents (DAAs). Fifteen KTRs with HCV infection were treated with DAAs (daclatasvir and sofosbuvir) for 3 months and monitored at baseline, end of treatment (EOT), and 3 (FU1) and 12 (FU2) months after EOT. Shear-wave speed (SWS) and loss angle of the complex shear modulus (φ), reflecting stiffness and fluidity, respectively, were reconstructed from multifrequency magnetic resonance elastography data with tomoelastography post-processing. After virus elimination by DAAs, hepatic stiffness and fluidity decreased, while kidney allograft stiffness and fluidity increased compared with baseline (hepatic stiffness change at FU1: -0.14 m/s, < 0.01, and at FU2: -0.11 m/s, < 0.05; fluidity at FU1: -0.05 rad, = 0.04 and unchanged at FU2: = 0.20; kidney allograft stiffness change at FU1: +0.27 m/s, = 0.01, and at FU2: +0.30 m/s, < 0.01; fluidity at FU1 and FU2: +0.06 rad, = 0.02). These results suggest the restoration of mechanically sensitive structures and functions in both organs. Tomoelastography can be used to monitor the therapeutic results of HCV treatment non-invasively on the basis of hepatic and renal viscoelastic parameters.
除肝脏外，丙型肝炎病毒（HCV）感染还会影响肾移植受者的肾移植。本研究的目的是纵向评估接受直接作用抗病毒药物（DAA）治疗的丙型肝炎病毒感染肾移植受者（KTR）肝脏和肾移植的粘弹性变化。15例丙型肝炎病毒感染的KTR接受DAA（达克替尼和索磷布韦）治疗3个月，并在基线、治疗结束时（EOT）以及EOT后3个月（FU1）和12个月（FU2）进行监测。分别反映硬度和流动性的剪切波速度（SWS）和复剪切模量的损耗角（φ），通过多频磁共振弹性成像数据经断层弹性成像后处理重建得到。DAA清除病毒后，与基线相比，肝脏硬度和流动性降低，而肾移植的硬度和流动性增加（FU1时肝脏硬度变化：-0.14 m/s，P<0.01；FU2时：-0.11 m/s，P<0.05；FU1时流动性：-0.05 rad，P = 0.04；FU2时无变化：P = 0.20；FU1时肾移植硬度变化：+0.27 m/s，P = 0.01；FU2时：+0.30 m/s，P<0.01；FU1和FU2时流动性：+0.06 rad，P = 0.02）。这些结果表明两个器官的机械敏感结构和功能得以恢复。断层弹性成像可基于肝脏和肾脏的粘弹性参数无创监测丙型肝炎病毒治疗的疗效。
