AUTHOR=Gu Li-hong , Lv Zi-cheng , Wu Hao-xiang , Hou Yu-Chen , Gao Run-lin , Xi Zhi-feng , Fang Hua , Feng Hao , Jiang Li-xin , Xia Qiang 

TITLE=Two-Dimensional Shear Wave Elastography Evaluation of Post-transplantation Complications in Pediatric Receipt: A Retrospective Cohort

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.918145

DOI=10.3389/fped.2022.918145

ISSN=2296-2360

ABSTRACT=BACKGROUND: The 20-year survival rate in pediatric patients after liver transplantation (LT) was no more than 70%. Hepatic fibrosis is one of the principal factors affecting the long-term prognosis. Imaging evaluation was the first-line examination for pediatric liver graft assessment. However, the sensitivity and specificity were insufficient. Thus, two-dimensional shear wave elastography (2D-SWE) was performed to evaluate liver graft stiffness and complication in post-transplant pediatric receipt.
METHODS: In this retrospective cohort, 343 pediatric recipients underwent liver graft biopsy in our tertiary LT center between June 2018 and December 2020 were recruited. The 2D-SWE evaluation, laboratory examination, routine post-transplant biopsy, and hepatic pathological assessment were performed. 
RESULTS: Ninety-eight of the 343 pediatric patients were included according to the protocol. The Liver Stiffness Measurements(LSM) value of 2D-SWE was significantly elevated in post-transplant fibrosis (p<0.0001). The LSM value of patients with post-transplant biliary complication(p<0.0001) and biopsy-proven rejection (BPR, p=0.0016) also rose compared to regular recovery patients. Concerning the sensitivity and specificity of 2D-SWE in diagnosing liver graft fibrosis, the area under the ROC curve was 88%, the optimal cutoff value was 10.3 kPa.  
CONCLUSIONS: Pediatric LSM by 2D-SWE was efficient. Routine 2D-SWE evaluation could be optimal to predict significant liver graft fibrosis.