Development of Clinical Algorithm Utilizing Vibration-Controlled Transient Elastography to Detect Advanced Hepatic Fibrosis in Liver Transplant Recipients

• DOI: 10.1007/s10620-024-08366-0
• Publication Date: 2024-03-18T17:32:53Z
• Authors: Tamoore Arshad; Dylan Vainer; Hiba Khan; Alok Baral; Shreya Garg; Audrey Ang; Vaishali Patel; Vinay Kumaran; David Bruno; Seung Lee; Amit Sharma; Mark Muthiah; Anh T. Bui; Mohammad Shadab S...
• Keywords: Transient elastography; Hepatic fibrosis

Vibration-controlled transient elastography (VCTE) based liver stiffness measurement (LSM) is an excellent 'rule-out' test for advanced hepatic fibrosis in transplant (LT) recipients, however, its ability to 'rule-in' the disease suboptimal. The study aimed improve diagnostic performance of LSM LT recipients. Adult recipients with a biopsy and VCTE were included (N = 150). Sequential covering analysis was performed create rules identify patients at low or high risk (stage 3–4). Advanced excluded either < 7.45 kPa (n 72) ≤ 12.1 time from 5.6 years 25). Conversely, likelihood 95% if had > 14.1 controlled attenuation parameter 279 dB/m 21). Thus, 118 (79%) correctly identified 32 (21%) would have required establish diagnosis. Compared previously established cutoff values 10.5 (Youden index) 13.3 (maximized specificity), false positive rates sequential 1% compared 16.5% ≥ 8.3% kPa. true comparable 87% analysis, 93% 83% proposed clinical allows better stratification when evaluating alone. Additional efforts are necessary further reduce number indeterminate results whom may be required.