Evaluation of hepatic fibrosis by transient elastography in βthalassemia children before and after hematopoietic stem cell transplantation

Abstract

Abstract Background Iron overload is a major concern in all patients with transfusion-dependent thalassemia (TDT). The liver, being a target for iron deposition is at risk of developing liver fibrosis or even cirrhosis. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment in clinical practice, a process that is surrounded by several precautions and complications that may affect the liver condition as well. Aim To evaluate the degree of hepatic fibrosis in children with TDT before and after HSCT. Methodology Twenty-five children with TDT who underwent HSCT were investigated by serum ferritin in addition to the assessment of liver fibrosis using transient elastography by FibroScan and liver fibrosis scores before and 1-year after HSCT. Results Out of the 25 children enrolled, only 16 completed a 1-year post-transplantation follow-up period. Slightly increased liver stiffness values measured by FibroScan 1-year post-transplantation, but the patients were still having the same degree of fibrosis of the pre-transplant period. FIB-4 score and APRI also showed statistically significant increase post-transplant as compared to pre-transplantation. Conclusion Stationary degree of fibrosis in thalassaemic children after HSCT with slight increases in the liver stiffness values by transient elastography that necessitates longer follow-up of the fibrosis status of patients’ post-transplant. Transient elastography is considered a helpful noninvasive tool for assessment of the hepatic status before and after HSCT.