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Accuracy of non-invasive liver stiffness measurement and steatosis quantification in patients with severe and morbid obesity

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Hepatobiliary Surgery and Nutrition 2021年第5期10卷 610-622,I0004-I0007页

作者： Magdalena Eilenberg Petra Munda Judith Stift Felix BLanger Gerhard Prager Michael Trauner katharina staufer Division of General Surgery Department of SurgeryMedical University of ViennaViennaAustria Department of Visceral Surgery and Medicine InselspitalUniversity Hospital BernBernSwitzerland Division of Gastroenterology&Hepatology Department of Internal Medicine IIIMedical University of ViennaViennaAustria Clinical Institute of Pathology Medical University of ViennaViennaAustria Division of Transplantation Department of SurgeryMedical University of ViennaViennaAustria

Background:Vibration controlled transient elastography(VCTE)and controlled attenuation parameter(CAP™)have shown reliable performance predicting fibrosis and steatosis in normal-to overweight patients but have not been validated in severe to morbid *** study aimed at determining the accuracy of VCTE,CAP™and the composite score FibroScan-AST(FAST)in patients with a body mass index(BMI)of≥35 kg/m^(2).Methods:Patients scheduled for bariatric-metabolic surgery underwent preoperative VCTE/CAP™measurement,and intraoperative liver *** feasibility and accuracy of VCTE,CAP™and the composite score FAST were retrospectively analysed to evaluate fibrosis,steatosis and active fibrotic non-alcoholic steatohepatitis[NASH+non-alcoholic fatty liver disease(NAFLD)activity score≥4+fibrosis grade≥2]using per protocol(PP)and intent to diagnose(ITD)***:In total,170 patients(median BMI 44.4 kg/m²)were included in the *** biopsy showed NASH,simple steatosis,and normal livers in 60.6%(n=103),28.8%(n=49),and 10.6%(n=18),*** and CAP™delivered reliable results in 90.6%(n=154/170)and 90.5%(n=134/148).The AUC(PP)of VCTE,CAP™,and FAST were 0.687(≥F2),0.786(≥F3),0.703(≥S2),0.738(S3),and 0.780(active fibrotic NASH).The AUC increased to 0.742(≥F2),0.842(≥F3),0.712(≥S2),0.780(S3),and 0.836(active fibrotic NASH)in patients below the median BMI of 44.4 kg/m².Conclusions:VCTE,CAP™and FAST show acceptable accuracy for the detection of fibrosis,steatosis and NASH in a real-life cohort of patients with *** improves in patients with a BMI<44.4 kg/m^(2).

关键词： Transient elastography controlled attenuation parameter(CAP™) FibroScan-AST score(FAST score) obesity non-alcoholic fatty liver disease(NAFLD)

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Biomarkers for detection of alcohol consumption in liver transplantation

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World Journal of Gastroenterology 2016年第14期22卷 3725-3734页

作者： katharina staufer Michel Yegles Division of Transplantation Department of Surgery Medical University of Vienna 1090 Vienna Austria Laboratoire National de Sante Service de Toxicologie medico-legale 1 rue Louis Rech L-3555 Dudelange Luxembourg

Alcoholic liver disease is an established, yet controversial, indication for liver transplantation. Although an abstinence period of up to 6 mo prior to transplantation is mandatory, alcohol relapse after transplantation is a common event. In case of recurrence of heavy drinking, graft survival is significantly impaired. Guidelines on detection and surveillance of alcohol consumption in this patient cohort are lacking. This review summarizes the challenge of patient selection as well as the current knowledge on established and novel alcohol biomarkers with special focus on liver transplant candidates and recipients.

关键词： Ethyl glucuronide Liver cirrhosis Short term alcohol markers Long-term alcohol markers Psychological

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