AUTHOR=Gülcicegi Dilan Elcin , Hannemann Jonathan , Bürger Martin , Allo Gabriel , Dittmann Eva , Martin Anna , Jaspers Natalie , Holzapfel Bianca , Seung-Hun Chon , Lang Sonja , Goeser Tobias , Steffen Hans-Michael , Kasper Philipp TITLE=Spleen stiffness measurements during recompensation in patients with acutely decompensated liver cirrhosis: preliminary findings of a pilot study JOURNAL=Frontiers in Medicine VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1475997 DOI=10.3389/fmed.2024.1475997 ISSN=2296-858X ABSTRACT=Background

Acute decompensation (AD) in patients with liver cirrhosis is associated with a dramatic deterioration in prognosis. Immediate initiation of appropriate recompensation measures is essential to improve patient’s outcome, although objective parameters for evaluating the success of recompensation are still lacking. Spleen stiffness measurements (SSM) have emerged as promising non-invasive tool to assess clinically significant portal hypertension (CSPH), which is the main driver of acute decompensation. However, while SSM accurately predicts CSPH and its complication, currently no data are available on its diagnostic performance during recompensation. This pilot-study aimed at evaluating changes in spleen stiffness following the initiation of recompensation measures in cirrhotic patients hospitalized due to AD.

Methods

In this prospective pilot-study, 60 patients with cirrhosis showing AD were included. Liver stiffness measurements (LSM) and SSM were performed on admission and repetitive SSM on day 3 and 5, respectivele, during recompensation measures. A cohort of patients (n = 10) with compensated cirrhosis served as control.

Results

A total of 36 data sets from the originally enrolled 60 patients were eligible for final analysis. On admission, patients with AD revealed a significantly increased spleen stiffness compared to the control group (70.51 vs. 29.06 kPa, p < 0.0001). Following the initiation of recompensation measures SSM revealed a significant reduction in spleen stiffness compared to the baseline assessment on day 3 (−18.5 kPa, −21.53%; p = 0.0002) with no further decrease on day 5 (−17.63 kPa, −21.23%; p = 0.0326).

Conclusion

Repetitive SSM seems to be a useful non-invasive clinical marker to assess the effectiveness of recompensation measures in cirrhotic patients with AD.