TE measures liver stiffness to assess fibrosis. Its use in post‐transplant patients was reported in few small pediatric studies. We evaluated TE ability to predict liver graft fibrosis in a large cohort while comparing it to the performance of APRI and FIB‐4. We also investigated the effect of graft type on LSMs. Patients at Boston Children's Hospital who underwent LT and LSM ≤ 1 year from biopsy (2007‐2018) were eligible. Ninety‐four patients (45%M) aged 1‐21 years (89% < 18 years; 13% < 2 years) were eligible. Median time between transplant/biopsy and LSM was 5.1 years and 52 days, respectively. Thirty‐nine percent received whole‐liver grafts, 54% TV grafts, and 6% as part of MV. At LSM, median ALT was 25 [IQR 16‐33] IU/L. Twenty‐one percent had METAVIR ≥ F2. LSM was statistically higher among those with significant fibrosis (METAVIR ≥ F2) compared to those with METAVIR F0/F1 (median [IQR] 7.5 [4.6, 13.6] vs 5.1 [4.0, 6.4] kPa, respectively) (P = .005 by Wilcoxon rank‐sum test). APRI and FIB‐4 distributions were not different across METAVIR stages. The AUROC for LSM was 0.71 (95% CI 0.56‐0.85) with an optimal cut‐point of 6.5 kPa. Graft type had no influence on the AUROC for LSM. TE is useful for assessing significant graft fibrosis in children and young adult LT recipients and performs better than APRI and FIB‐4. TV grafts demonstrate similar correlation with histology as whole‐liver grafts.

中文翻译：

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儿科移植受者肝脏同种异体移植纤维化的瞬时弹性成像评估。

TE 测量肝脏硬度以评估纤维化。少数小型儿科研究报告了其在移植后患者中的应用。我们在一个大型队列中评估了 TE 预测肝移植纤维化的能力，同时将其与 APRI 和 FIB-4 的性能进行了比较。我们还研究了接枝类型对 LSM 的影响。波士顿儿童医院接受 LT 和 LSM ≤ 1 年（2007-2018 年）活检的患者符合条件。94 名 1-21 岁（89% < 18 岁；13% < 2 岁）的患者（45% M）符合条件。移植/活检和 LSM 之间的中位时间分别为 5.1 年和 52 天。39% 接受全肝移植，54% 接受 TV 移植，6% 作为 MV 的一部分。在 LSM，中位 ALT 为 25 [IQR 16-33] IU/L。21% 的患者 METAVIR ≥ F2。 通过 Wilcoxon 秩和检验P = .005）。APRI 和 FIB-4 分布在 METAVIR 阶段没有不同。LSM 的 AUROC 为 0.71（95% CI 0.56-0.85），最佳临界点为 6.5 kPa。移植物类型对 LSM 的 AUROC 没有影响。TE 可用于评估儿童和年轻成人 LT 受者的显着移植物纤维化，并且比 APRI 和 FIB-4 表现更好。TV 移植物表现出与全肝移植物相似的组织学相关性。