Sonographic Evaluation of Liver Elasticity Shows Promise in Predicting Post Liver Transplant HCV Recurrence

A sonography-based evaluation of liver elasticity is a promising tool in evaluating recurrence of hepatitis C virus (HCV) in postorthotopic liver transplant (OLT) patients, but further research is needed before the technique replaces biopsy as the standard of reference, according to a recent study.

Published online on May 28, 2014, in the World Journal of Gastroenterology, the study examines research on post-OLT complications in adult patients and future possibilities in the surveillance of patients with HCV recurrence. The study authors note HCV is the most common indication for OLT, with the overall graft and patient survival rates 23% lower in HCV-infected OLT recipients compared with non-HCV infected patients.

Within 3 years of the diagnosis of reinfection, chronic hepatitis occurs in up to 63% of patients, with cirrhosis evolving more rapidly in HCV-infected patients who received OLT versus non-OLT patients, according to the study. The researchers find state-of-the-art transient elastography is a useful complement to biopsy to exclude cirrhosis in patients who are not candidates for treatment or who have evidence of advanced fibrosis.

The study also notes that shear wave elastography shows promise in detecting rejection or recurrent HCV within 4 weeks after OLT in both HCV- infected and non-infected patients. Due to the challenge of HCV recurrence, the study suggests a need to go beyond conventional imaging with noninvasive modalities of graft assessments.