HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202018000100321 |
Resumo: | ABSTRACT Background: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. Aim: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. Method: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. Results: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7±6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73±22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65±22.2 kPa vs. 50.87±20.9 kPa (p=0.098) and higher MELD scores (p=0.035). Conclusion: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality. |
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ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
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HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LISTLiver transplantationEnd-stage liver diseaseLogistic modelsSurvival analysis.ABSTRACT Background: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. Aim: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. Method: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. Results: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7±6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73±22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65±22.2 kPa vs. 50.87±20.9 kPa (p=0.098) and higher MELD scores (p=0.035). Conclusion: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality.Colégio Brasileiro de Cirurgia Digestiva2018-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202018000100321ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.31 n.1 2018reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/0102-672020180001e1360info:eu-repo/semantics/openAccessNACIF,Lucas SoutoPARANAGUA-VEZOZZO,Denise CMATSUDA,AlinaALVES,Venancio Avancini FerreiraCARRILHO,Flair JFARIAS,Alberto QueirozD’ALBUQUERQUE,Luiz CarneiroANDRAUS,Wellingtoneng2018-06-18T00:00:00Zoai:scielo:S0102-67202018000100321Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2018-06-18T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false |
dc.title.none.fl_str_mv |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
title |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
spellingShingle |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST NACIF,Lucas Souto Liver transplantation End-stage liver disease Logistic models Survival analysis. |
title_short |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
title_full |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
title_fullStr |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
title_full_unstemmed |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
title_sort |
HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST |
author |
NACIF,Lucas Souto |
author_facet |
NACIF,Lucas Souto PARANAGUA-VEZOZZO,Denise C MATSUDA,Alina ALVES,Venancio Avancini Ferreira CARRILHO,Flair J FARIAS,Alberto Queiroz D’ALBUQUERQUE,Luiz Carneiro ANDRAUS,Wellington |
author_role |
author |
author2 |
PARANAGUA-VEZOZZO,Denise C MATSUDA,Alina ALVES,Venancio Avancini Ferreira CARRILHO,Flair J FARIAS,Alberto Queiroz D’ALBUQUERQUE,Luiz Carneiro ANDRAUS,Wellington |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
NACIF,Lucas Souto PARANAGUA-VEZOZZO,Denise C MATSUDA,Alina ALVES,Venancio Avancini Ferreira CARRILHO,Flair J FARIAS,Alberto Queiroz D’ALBUQUERQUE,Luiz Carneiro ANDRAUS,Wellington |
dc.subject.por.fl_str_mv |
Liver transplantation End-stage liver disease Logistic models Survival analysis. |
topic |
Liver transplantation End-stage liver disease Logistic models Survival analysis. |
description |
ABSTRACT Background: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. Aim: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. Method: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. Results: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7±6.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73±22.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m/s and 2.16 (0.59-2.8) m/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p<0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65±22.2 kPa vs. 50.87±20.9 kPa (p=0.098) and higher MELD scores (p=0.035). Conclusion: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202018000100321 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202018000100321 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0102-672020180001e1360 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
publisher.none.fl_str_mv |
Colégio Brasileiro de Cirurgia Digestiva |
dc.source.none.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.31 n.1 2018 reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD) instacron:CBCD |
instname_str |
Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
instacron_str |
CBCD |
institution |
CBCD |
reponame_str |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
collection |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) |
repository.name.fl_str_mv |
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD) |
repository.mail.fl_str_mv |
||revistaabcd@gmail.com |
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1754208958277484544 |