Hepatic magnetic resonance elastography: can it be an alternative to invasive biopsy preceding living donor liver transplantation?

Abstract

Abstract Background Recently, the living donor liver transplantation (LDLT) surgery is employed as the treatment of choice for end-stage chronic liver disease and hepatocellular carcinoma. The role of liver biopsy in donor’s selection protocol for adult living liver donors (LLDs) candidates is a point of controversy. Hepatic magnetic resonance elastography (MRE) is a promising technique particularly in grading of liver fibrosis that can be used for pre-transplantation evaluation of the LLDs candidates. The aim of the current study was to evaluate the diagnostic performance of hepatic MRE as a pre-transplantation imaging tool for LLDs candidates, prior to LDLT surgery. Results Thirty-seven eligible healthy LLDs candidates (28 males and 9 females; their ages ranged from 24 to 45 years) were the subject of the current study. A cut-off value ≥ 2.24 kilo Pascal (kPa) was assumed for discrimination between normal and abnormal hepatic tissues with high accuracy (99.24%). Also, a cut-off value ≥ 2.38 kPa for grading steatosis gave 98.44% accuracy, while a cut-off value ≥ 2.57 kPa for discriminating fibrosis stages yielded 98.80% accuracy. Conclusion MRE can be considered as a reliable non-invasive pre-transplant screening technique that has the potential to alternate the invasive liver biopsy technique in selection and validation of LLDs candidates for LDLT surgery.

Keywords

• Magnetic resonance elastography
• Living donors
• Liver transplantation
• Biopsy
• Liver