Transient elastography correlates with liver injury in PSC patients: Laennec score-based analysis of explanted livers

M Krawczyk; J Ligocka; M Ligocki; J Raszeja-Wyszomirska; M Milkiewicz; G Szparecki; T Ilczuk; B Górnicka; K Zieniewicz; M Krawczyk; F Lammert; P Milkiewicz

doi:10.1055/s-0037-1605089

Zeitschrift für Gastroenterologie, Inhaltsverzeichnis

Z Gastroenterol 2017; 55(08): e57-e299
DOI: 10.1055/s-0037-1605089

Kurzvorträge

Leber und Galle

PBC, PSC und AIH: Was müssen wir wissen?: Freitag, 15 September 2017, 08:30 – 09:50, St. Petersburg/Forschungsforum 1

Georg Thieme Verlag KG Stuttgart · New York

Transient elastography correlates with liver injury in PSC patients: Laennec score-based analysis of explanted livers

Authors

M Krawczyk

¹Saarland University Hospital, Department of Medicine II, Homburg, Deutschland

²Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
J Ligocka

³Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
M Ligocki

⁴Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
J Raszeja-Wyszomirska

⁴Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
M Milkiewicz

⁵Department of Medical Biology, Pomeranian Medical University, Szczecin, Polen
G Szparecki

⁶Department of Pathology, Medical University of Warsaw, Warsaw, Polen
T Ilczuk

⁶Department of Pathology, Medical University of Warsaw, Warsaw, Polen
B Górnicka

⁶Department of Pathology, Medical University of Warsaw, Warsaw, Polen
K Zieniewicz

³Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
M Krawczyk

³Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen
F Lammert

¹Saarland University Hospital, Department of Medicine II, Homburg, Deutschland
P Milkiewicz

⁴Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Polen

Abstract

Volltext

Background and aim:

Previous studies demonstrated a close correlation between transient elastography (TE) and liver biopsy, in particular in patients with chronic viral hepatitis. However, biopsy restricts the analysis to only a small part of the liver parenchyma. Moreover, data on the accuracy of TE in primary sclerosing cholangitis (PSC) remains scarce. Here we investigated the association between TE, serum marker of portal hypertension (sVCAM-1) and histology of explanted livers in PSC patients.

Methods:

Prospectively we recruited 30 patients with PSC (12 women, age 35.6 ± 12.2 years). TE (Fibroscan®) and blood sampling were performed during evaluation for liver transplantation (LT); a second blood sample was taken at the day of LT. Explanted livers were assessed according to the recently proposed, extended Laennec staging system, which comprises seven stages of liver fibrosis and measures mean thickness of fibrotic septa (J Hepatol 2012). Liver scarring was also quantified via measurement of hepatic collagen contents. Serum sVCAM1 was determined using ELISA.

Results:

TE correlated with collagen contents and Laennec stages of fibrosis (both P < 0.001) as well as with the diameter of thickest septa (P = 0.034) in explanted livers. It also correlated with serum bilirubin, AST, sVCAM-1 as well as with FIB-4 and APRI scores (all P < 0.05). In multivariate regression analysis, only liver fibrosis according to either collagen contents or Leannec score was significantly (P = 0.005 and P = 0.035, respectively) associated with TE. Cirrhotics had increased liver stiffness (P = 0.002), and the TE cut-off of 13.7 kPa had the best predictive value (AUC = 0.90, 95%CI 0.80 – 1.00, P < 0.001) for detecting cirrhosis.

Conclusions:

We demonstrate for the first time that in patients with PSC transient elastography correlates with liver fibrosis quantified in explanted livers. Moreover, it correlates with portal hypertension. Hence, we conclude that elastography is a reliable tool for non-invasive monitoring of PSC patients awaiting liver transplantation.