Ultrasound IDs Post-Transplant Recurrent Hep C Cirrhosis

Transient elastography detects cirrhosis from recurrent HCV; less accurate for chronic infection

MONDAY, March 5 (HealthDay News) -- Ultrasound-based transient elastography (TE) provides diagnostic accuracy for detecting cirrhosis due to recurrent hepatitis C virus (HCV) infection following liver transplantation, according to a meta-analysis published in the March issue of Liver Transplantation.

Corlan O. Adebajo, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a systematic review and diagnostic accuracy meta-analysis of the literature comparing ultrasound-based TE with liver biopsies for detection of hepatic fibrosis due to post-liver transplant recurrent HCV infection. Six studies were included in the analysis.

The researchers found that, for five of the studies that evaluated significant fibrosis, the pooled estimates were 83 percent for sensitivity, 83 percent for specificity, 4.95 for the positive likelihood ratio, 0.17 for the negative likelihood ratio, and 30.5 for the diagnostic odds ratio. The pooled estimates for the five studies that evaluated cirrhosis were 98 percent for sensitivity, 84 percent for specificity, 7 for the positive likelihood ratio, 0.06 for the negative likelihood ratio, and 130 for the diagnostic odds ratio. An important cause of heterogeneity for the pooled results of both patient groups was the diagnostic threshold (or cut-off value) bias.

"Ultrasound-based TE has excellent diagnostic accuracy for identifying cirrhosis due to a recurrent HCV infection after LT," the authors write. "The detection of significant fibrosis is more accurate for these patients versus patients whose native liver is chronically infected with HCV."

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