Spleen transient elastography predicts actuarial survival after liver transplantation

Background: Splenic transient elastography (TE) correlates with increased portal pressure. Little data are available in the post liver transplantation (LTx) setting. Methods: Three months after LTx, we performed splenic TE in 125 LTx recipients. Results: Mean splenic TE values were 29.4 (+/- 6.3; range, 21.6-49.2) kPa. Splenic TE correlated with reduced time to development until persistent ascites (30 events, OR = 1.082, 95% CI: 1.034-1.133; P = 0.001), hepatorenal syndrome (8 events, OR = 1.109, 95% CI: 1.015-1.211; P = 0.022) and hepatic encephalopathy (16 events, OR = 1.136, 95% CI: 1.066-1.211; P = 0.000). In Cox univariate analysis, splenic TE served as a predictor of actuarial survival free of liver (OR = 1.114, 95% CI: 1.050-1.182; P < 0.001) and remained an independent risk factor associated with reduced actuarial survival free of LTx in multivariate analysis (OR = 1.103, 95% CI: 1.026-1.186; P = 0.008). Conclusions: Splenic TE measurement at 3 months after LTx serves as a robust predictor of survival in LTx recipients.