设拉子器官移植中心对肝移植术后儿童使用瞬时弹性成像技术通过测量肝脏硬度来确定同种异体移植物纤维化情况。
Determination of allograft fibrosis by measurement of liver stiffness using transient elastography in children after liver transplantation at Shiraz Organ Transplant Center.
作者信息
Dehghani Seyed Mohsen, Ataollahi Maryam, Hedayati Seyyed Bozorgmehr, Parooie Fateme, Shahramian Iraj
机构信息
Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz ,Iran.
出版信息
Gastroenterol Hepatol Bed Bench. 2021 Fall;14(4):311-316.
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 ( = 0.01), total bilirubin ( = 0.002), albumin ( = 0.001), PT ( = 0.03), and INR ( = 0.001) were significant. There was no significant relationship between FS score (LS) and type of allograft ( = 0.79) and underlying disease ( = 0.36). Positive and significant correlations were observed between Metavir score and AST ( = 0.01), total bilirubin ( = 0.01), INR ( = 0.004), and cholesterol ( = 0.001). The severity of fibrosis significantly and negatively correlated with albumin ( = 0.004) and glucose ( = 0.003). Also, there was no significant relationship between Metavir score and allograft type ( = 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.
目的
本研究的目的是通过在设拉子器官移植中心对肝移植术后儿童使用瞬时弹性成像（TE）测量肝脏硬度（LS）来确定同种异体移植物纤维化情况。
背景
使用纤维扫描（瞬时弹性成像 - TE）评估肝脏硬度是一种评估肝纤维化的非侵入性方法。
方法
纳入2012年至2016年期间所有接受肝移植的儿童。从患者记录中获取人口统计学数据、移植物类型、免疫抑制药物以及临床和辅助临床数据。对所有患者进行TE以确定LS。还根据梅塔维（Metavir）评分确认肝纤维化情况。
结果
在此期间，儿童进行了400多次肝移植，但只有54名接受肝移植的患者（包括20名（37%）女孩和34名（63%）男孩）可参与且愿意参与本研究。患者的平均年龄为12.96±5.32岁。纤维扫描评分（LS）与谷草转氨酶（AST）（r = 0.01）、总胆红素（r = 0.002）、白蛋白（r = 0.001）、凝血酶原时间（PT）（r = 0.03）和国际标准化比值（INR）（r = 0.001）之间的相关性显著。纤维扫描评分（LS）与同种异体移植物类型（r = 0.79）和基础疾病（r = 0.36）之间无显著关系。梅塔维评分与AST（r = 0.01）、总胆红素（r = 0.01）、INR（r = 0.004）和胆固醇（r = 0.001）之间观察到正相关且显著相关。纤维化严重程度与白蛋白（r = 0.004）和葡萄糖（r = 0.003）之间显著负相关。此外，梅塔维评分与同种异体移植物类型之间无显著关系（r = 0.7）。
结论
当前研究表明，14.9%的肝移植患者梅塔维评分≥F2。肝移植与TE之间的时间与LS以及基于梅塔维评分的肝纤维化程度显著相关。然而，LS与同种异体移植物类型或基础肝脏疾病之间无显著关系。
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