Korean J Transplant.  2020 Dec;34(Supple 1):S12. 10.4285/ATW2020.OR-1201.

Liver stiffness measurement and outcomes of living donor liver transplantation

• Kim SJ
• Kim JM
• Rhu J
• Choi GS
• Park JB
• Joh JW

• KMID: 2509132
• DOI: http://doi.org/10.4285/ATW2020.OR-1201

Abstract

Background
Liver stiffness measurement (LSM) is a non-invasive method for evaluating liver fibrosis. The aim of this study was to evaluate the correlation between LSM and outcomes of living donor liver transplantation.
Methods
From January 1, 2014 to May 30, 2019, patients who received living donor liver transplantation were evaluated by Fibroscan. Baseline characteristics, preoperative donor LSM, and recipient 1-month and 1-year postoperative LSM were evaluated. Graft survival, patient survival, HCC recurrence, and rejection were analyzed with LSM values.
Results
Total 237 patients who received living donor liver transplantation were included, retrospectively. One hundred and seventy-four patients were infected with hepatitis B virus. Donor LSM was evaluated in 233 patients, 1-month LSM in 206 patients, and 1-year LSM in 62 patients. Either donor LSM, recipient 1-month, or 1-year LSM did not significantly affect graft survival and HCC recurrence. High donor LSM was associated with patient death, especially when donor LSM was more than 5 kPa (hazard ratio [HR], 3.58; P=0.004). Regarding T-cell mediated rejection (TCMR), high 1-year LSM was associated with high risk, especially when the 1-year LSM was more than 8 kPa (HR, 5.42; P=0.008; multivariate). One-year LSM (>8 kPa) was also associated with TCMR occurring after 1 year (HR, 7.01; P=0.047; multivariate). In hepatitis B virus patients, LSM had a greater influence on patient death and TCMR.
Conclusions
Preoperative donor LSM more than 5 kPa was significantly associated with patient death. Recipient 1-year LSM more than 8 kPa was associated with both TCMR over the entire period and TCMR 1-year after transplantation. This tendency was slightly more pronounced when patients were infected with hepatitis B virus.