Pediatr Transplant. 2025 Aug;29(5):e70120. doi: 10.1111/petr.70120.
ABSTRACT
BACKGROUND: Liver biopsy is the gold standard for assessing liver allograft fibrosis but is invasive and carries risks, especially in pediatric liver transplant (PLT) recipients. Two-dimensional shear wave elastography (2D-SWE) has emerged as a promising noninvasive alternative. This study aimed to assess 2D-SWE in evaluating children post-liver transplantation (LTx) and to identify clinical and laboratory predictors of liver stiffness.
METHODS: In this prospective case-control study, 20 PLT recipients and 20 healthy age- and sex-matched controls were imaged using a GE LOGIQ E10 scanner. Median stiffness, interquartile range (IQR), and IQR/median ratio were calculated based on 12 liver stiffness measurements (LSM). Comparisons between LTx recipients and controls were conducted to determine differences in LSM. A 5.96 kPa cut-off was used to define elevated LSM. Additionally, associations between liver stiffness and demographic data and laboratory findings were assessed to identify potential predictors.
RESULTS: PLT patients exhibited significantly higher liver stiffness compared to controls. No significant differences were observed in ultrasound-guided attenuation parameter (UGAP) scores between the two groups. 44.4% of PLT recipients were above the 5.96 kPa cut-off. Exploratory analyses did not identify significant clinical or laboratory predictors of increased liver stiffness.
CONCLUSIONS: 2D-SWE is an effective noninvasive tool for assessing liver stiffness in PLT recipients, demonstrating significantly elevated stiffness compared to healthy controls. Elevated or increasing LSMs may necessitate a liver biopsy, thereby reducing the reliance on routine biopsies as standard protocol. Further studies with larger cohorts are needed to validate SWE cut-off values and explore its longitudinal utility.
PMID:40590071 | DOI:10.1111/petr.70120
