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Spleen Stiffness Can Non-invasively Assess Resolution of Portal Hypertension after Liver Transplantation.
MedLine Citation:
PMID:  25074281     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Spleen stiffness can be measured by transient elastography. Recent studies have shown that spleen stiffness correlates with hepatic venous pressure gradient and can predict oesophageal varices. Elevated spleen stiffness in cirrhosis has been attributed to splenic tissue hyperplasia and fibrosis, portal hypertension and its consequent hyperdynamic circulation.
AIMS: The aim of this study was to investigate changes to spleen stiffness after orthotopic liver transplantation (OLT) when portal hypertension resolves.
METHODS: 21 patients awaiting OLT were studied prospectively while 11 post-transplant patients were recruited as controls. Spleen and liver stiffness were measured with Fibroscan before and at 2 to 8 weeks after OLT. Criteria applied for spleen stiffness measurement were similar to liver stiffness (≥10 measurements; ≥60% success rate; interquartile range, IQR<30% of median).
RESULTS: Spleen stiffness was significantly higher before OLT compared to post-transplant patients [75.0(63.9-75.0)kPa versus 28.4(22.0-37.5)kPa; p<0.0001). 90% (19/21) of patients awaiting OLT had oesophageal varices (endoscopically or radiologically). In patients who underwent liver transplantation, spleen stiffness decreased significantly from a median of 75.0(62.0-75.0)kPa before OLT, to 41.9(27.0-47.4)kPa at 2 weeks after transplant and 32.9(29.1-38.0)kPa in the subsequent 4 to 8 weeks after OLT (p<0.0001). As expected, liver stiffness measurements reduced from 39.3(24.9-75.0)kPa to 8.6(6.8-11.8)kPa in patients receiving OLT (p=0.0004).
CONCLUSIONS: Spleen stiffness can non-invasively assess changes in portal pressure after liver transplantation and decreases significantly when portal hypertension resolves. This article is protected by copyright. All rights reserved.
Authors:
Jun Liong Chin; Grace Chan; John D Ryan; P Aiden McCormick
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-29
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  -     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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