Application Value Of Shear Wave Elastography In Assessment Of Liver Grafts From Brain Death Donor

Objective:To investigate the value of shear wave elastography(SWE)in evaluating the liver grafts from brain death donor(DBD)by detecting the liver stiffness of the liver grafts and analyzing the relationship between SWE of DBD and early allograft function of liver transplant recipients.Methods:Thirty-nine cases of DBD from March 2017 to May 2018 were included in the study.The clinic data of donors including sex,age,cause of death,ultrasonography,SWE,AST,ALT,TBIL and INR before operation,were recorded.The recipient data including sex,age,primary disease,surgical approach,MELD score,TBIL and INR were recorded.Donors and their recipients were classified into two groups by early allograft function of transplant recipients: early allograft dysfunction(EAD)group(20 donors and 20recipients)and early allograft function normal(non-EAD)group(19 donors and 19recipients).The followings were analyzed by SPSS 17.0 statistical software :(1)The differences in donor sex,age,liver SWE,ultrasonic grading,recipient sex and age between EAD group and non-EAD group;(2)The independent affective factor of EAD;(3)Comparison of diagnosis performance between SWE and ultrasonic grading and finding the cutoff value to predict EAD after transplantation by receiver operating characteristic(ROC)curve.Results:(1)The result showed that the SWE value(P<0.001),Ultrasonic grading(P=0.002),MELD score(P=0.005)and TBIL(P=0.020)of EAD group were significantly higher than those of non-EAD group,but there was no significant difference in donor and recipient sex or age,donor portal venous flow or laboratory data(P>0.05);(2)The logistic regression revealed that SWE value was the independent affective factor of EAD(P=0.013);(3)The ROC curve revealed that the optimal cut-off value of SWE was4.56kPa(area under ROC curve(AUC)=0.939,sensitivity 90.0%,specificity 78.9%,P<0.001),the optimal cut-off value of ultrasonic grading was level 3.5(AUC=0.806,sensitivity 86.7%,specificity 70.6%,P=0.003),the optimal cut-off value of MELD score was 11.05(AUC=0.739,sensitivity 65.0%,specificity 84.2%,P=0.011),the optimal cut-off value of TBIL of transplant recipient was 35.5 μmol/L(AUC=0.717,sensitivity85.0%,specificity 63.2%,P=0.020).Conclusion:SWE is able to assess the liver stiffness of DBD in a convenient way and has good diagnosis performance in predicting EAD after liver transplantation.SWE is likely to improve the assessment of liver grafts from DBD.