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活体肝移植中应用受控衰减参数无创性评估肝脂肪变。

Noninvasive Estimation of Hepatic Steatosis by Controlled Attenuation Parameter in Living Donor Liver Transplant.

机构信息

From the Shiraz Transplant Center, Abu-Ali Sina Hospital, Shiraz, Iran.

出版信息

Exp Clin Transplant. 2022 Jul;20(7):674-679. doi: 10.6002/ect.2021.0181. Epub 2021 Sep 20.

DOI:10.6002/ect.2021.0181
PMID:34546155
Abstract

OBJECTIVES

Estimation of liver fat among living donor candidates is necessary before living donor liver transplant. This study aimed to investigate the usefulness of the controlled attenuation parameter compared with liver biopsy for pretransplant estimation of hepatic steatosis in living liver donors.

MATERIALS AND METHODS

In this retrospective study, we included all individuals who underwent transient elastography with controlled attenuation parameter and ultrasonography-guided liver biopsy as a part of donor evaluations before living donor liver transplant. Clinical and laboratory data of living donor candidates were reviewed and collected.

RESULTS

Of 49 donor candidates included in this study, 21 (42.9%) had different degrees of hepatic macrosteatosis. Of the 21 donor candidates who had hepatic steatosis in liver biopsy, 13 individuals were diagnosed to have steatosis in transient elastography. Of the 28 donor candidates without hepatic steatosis in liver biopsy, 26 individuals showed no steatosis in transient elastography (odds ratio: 21.12; 95% CI, 3.91- 114.08; P < .001). Controlled attenuation parameter was useful in discriminating presence (P = .001) and grade of hepatic steatosis (P = .009) compared with liver biopsy with good sensitivity and specificity.

CONCLUSIONS

The controlled attenuation parameter is a noninvasive method for detection of hepatic steatosis in living donor candidates and can be used as an adjunct to liver biopsy for screening of living donor candidates before liver transplant.

摘要

目的

在进行活体肝移植前,需要对活体供肝候选者的肝脂肪进行评估。本研究旨在探讨受控衰减参数(controlled attenuation parameter,CAP)与肝活检相比,在活体肝供者移植前评估肝脂肪变性中的作用。

材料与方法

本回顾性研究纳入了所有在活体肝移植前接受过瞬时弹性成像和超声引导下肝活检的个体。回顾并收集了活体供肝候选者的临床和实验室数据。

结果

本研究共纳入 49 名供肝候选者,其中 21 名(42.9%)存在不同程度的肝脂肪变性。在 21 名肝活检有脂肪变性的供肝候选者中,13 名在瞬时弹性成像中被诊断为脂肪变性。在 28 名肝活检无脂肪变性的供肝候选者中,26 名在瞬时弹性成像中无脂肪变性(比值比:21.12;95%可信区间:3.91~114.08;P <.001)。与肝活检相比,CAP 可更好地区分肝脂肪变性的存在(P =.001)和程度(P =.009),具有良好的敏感性和特异性。

结论

CAP 是一种检测活体供肝候选者肝脂肪变性的非侵入性方法,可作为肝活检的辅助手段,用于活体肝移植前供肝候选者的筛查。

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