serial liver stiffness measurements and monitoring of livertransplanted patients in a reallife clinical practice

Background: liver transplanted patients need close surveillance for early signs of graft disease.objectives: transient elastography can safely be repeated over time, offering serial liver stiffness measurement values. serial stiffness measurements were compared to single baseline stiffness measurements in predicting the appearance of liver-related clinical events and guiding subsequent clinical decisions. methods: one hundred and sixty liver transplanted patients were observed for three years in our real-life practice. results: liver stiffness measurements were stable in 75% of patients, decreased in 4% of patients, and increased in 21% of patients. the pattern of increased stiffness measurements was associated with both hcv-rna positive status and the presence of an active biliary complication of liver transplantation and was more predictive of a clinically significant event resulting from any disease of the transplanted liver when compared to a stable pattern or to a single liver stiffness measurement. the procedures that were consequently performed were often diagnostic for unexpected situations, both in hcv-rna positive and hcv-rna negative patients. conclusions: the pattern of longitudinally increased liver stiffness measurements efficiently supported clinical decisions for individualized management strategies. repeated transient elastography in real-life clinical practice appears to have a practical role in monitoring liver transplanted patients.