Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium; Laboratory of Gastroenterology and Hepatology, Institut de Recherche Expérimentale et Clinique, UCLouvain, Brussels, Belgium.
Clin Res Hepatol Gastroenterol. 2023 Oct;47(8):102194. doi: 10.1016/j.clinre.2023.102194. Epub 2023 Aug 9.
As life expectancy of liver transplanted patients improves, new questions are arising to avoid progressive graft loss. The spectrum of chronic inflammation and fibrosis are known to be important triggers in the alteration of graft function. Liver biopsy remains the gold standard to better understand progressive, normal, and abnormal histological modifications of the graft. In parallel, the interest for metabolic steatosis development in post-transplantation is also growing. Long-term survival of these patients involves the management of comorbidities including metabolic syndrome and cardiovascular diseases. Early detection of altered graft parenchyma, and monitoring of its evolution are undoubtedly essential. Non-invasive methods including transient elastography and fibrosis biomarkers are attractive tools to avoid drawbacks and complications of liver biopsy. Accuracy of these methods are well-known in a pre-transplantation setting, but evidence is lacking in post-transplantation setting. We review current knowledge of progressive liver fibrosis and steatosis development after transplantation and non-invasive methods of their assessment.
随着肝移植患者预期寿命的延长，新的问题不断出现，以避免移植物进行性丧失。慢性炎症和纤维化的范围被认为是改变移植物功能的重要触发因素。肝活检仍然是更好地了解移植物进行性、正常和异常组织学改变的金标准。与此同时，人们对移植后代谢性脂肪变性发展的兴趣也在增长。这些患者的长期生存需要管理包括代谢综合征和心血管疾病在内的合并症。早期发现移植物实质的改变，并监测其演变无疑是至关重要的。瞬时弹性成像和纤维化生物标志物等非侵入性方法是避免肝活检的缺点和并发症的有吸引力的工具。这些方法在移植前的准确性是众所周知的，但在移植后的证据不足。我们回顾了肝移植后进行性肝纤维化和脂肪变性发展的最新知识，以及评估这些疾病的非侵入性方法。
