{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:50:20Z","timestamp":1777535420017,"version":"3.51.4"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"abstract":"<jats:p>ABSTRACT Background: Liver elastography have been reported in hepatocellular carcinoma (HCC) with higher values; however, it is unclear to identify morbimortality risk on liver transplantation waiting list. Aim: To assess liver stiffness, ultrasound and clinical findings in cirrhotic patients with and without HCC on screening for liver transplant and compare the morbimortality risk with elastography and MELD score. Method: Patients with cirrhosis and HCC on screening for liver transplant were enrolled with clinical, radiological and laboratory assessments, and transient elastography. Results: 103 patients were included (without HCC n=58 (66%); HCC n=45 (44%). The mean MELD score was 14.7\u00b16.4, the portal hypertension present on 83.9% and the mean transient elastography value was 32.73\u00b122.5 kPa. The median acoustic radiation force impulse value of liver parenchyma was 1.98 (0.65-3.2) m\/s and 2.16 (0.59-2.8) m\/s in HCC group. The HCC group was significantly associated with HCV infection (OR 26.84; p&lt;0.0001), higher levels of serum alpha-fetoprotein (OR 5.51; p=0.015), clinical portal hypertension (OR 0.25; p=0.032) and similar MELD score (p=0.693). The area under the receiver operating characteristics (AUROC) showed sensitivity and specificity for serum alpha-fetoprotein (cutoff 9.1 ng\/ml), transient elastography value (cutoff value 9 kPa), and acoustic radiation force impulse value (cutoff value 2.56 m\/s) of 50% and 86%, 92% and 17% and 21% and 92%, respectively. The survival group had a mean transient elastography value of 31.65\u00b122.2 kPa vs. 50.87\u00b120.9 kPa (p=0.098) and higher MELD scores (p=0.035). Conclusion: Elastography, ultrasound and clinical findings are important non-invasive tools for cirrhosis and HCC on screening for liver transplant. Higher values in liver elastography and MELD scores predict mortality.<\/jats:p>","DOI":"10.1590\/0102-672020180001e1360","type":"journal-article","created":{"date-parts":[[2018,6,27]],"date-time":"2018-06-27T15:47:40Z","timestamp":1530114460000},"source":"Crossref","is-referenced-by-count":6,"title":["HIGHER VALUES IN LIVER ELASTOGRAPHY AND MELD SCORE ARE MORTALITY PREDICTORS ON LIVER TRANSPLANT WAITING LIST"],"prefix":"10.1590","volume":"31","author":[{"given":"Lucas Souto","family":"NACIF","sequence":"first","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise C","family":"PARANAGUA-VEZOZZO","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"MATSUDA","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venancio Avancini Ferreira","family":"ALVES","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flair J","family":"CARRILHO","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto Queiroz","family":"FARIAS","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Carneiro","family":"D\u2019ALBUQUERQUE","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wellington","family":"ANDRAUS","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2018,6,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/1471-230X-11-91","article-title":"Non-invasive markers for hepatic fibrosis","volume":"11","author":"Baranova A","year":"2011","journal-title":"BMC Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1002\/hep.24199","article-title":"Management of hepatocellular carcinoma an update","volume":"53","author":"Bruix J","year":"2011","journal-title":"Hepatology"},{"issue":"2","key":"ref3","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jhep.2012.03.016","article-title":"ARFI, FibroScan, ELF, and their combinations in the assessment of liver fibrosis a prospective study","volume":"57","author":"Crespo G","year":"2012","journal-title":"J Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/S0016-5085(58)80085-2","article-title":"An evaluation of the problem of hepatic cirrhosis as seen in S\u00e3o Paulo, Brazil. III. Postnecrotic cirrhosis; clinical aspects","volume":"34","author":"Da Silva LC","year":"1958","journal-title":"Gastroenterology"},{"issue":"6","key":"ref5","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1586\/erd.10.46","article-title":"Transient elastography for the diagnosis of liver fibrosis","volume":"7","author":"de L\u00e9dinghen V","year":"2010","journal-title":"Expert Rev Med Devices"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jhep.2011.12.001","article-title":"Management of hepatocellular carcinoma","volume":"56","year":"2012","journal-title":"Hepatol"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1136\/gut.2005.069153","article-title":"Diagnosis of cirrhosis by transient elastography (FibroScan) a prospective study","volume":"55","author":"Foucher J","year":"2006","journal-title":"Gut"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.jhep.2006.11.010","article-title":"Features associated with success rate and performance of FibroScan measurements for the diagnosis of cirrhosis in HCV patients a prospective study of 935 patients","volume":"46","author":"Kettaneh A","year":"2007","journal-title":"J Hepatol"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.ultrasmedbio.2013.08.011","article-title":"Effects of vascularity and differentiation of hepatocellular carcinoma on tumor and liver stiffness in vivo and in vitro studies","volume":"40","author":"Ling W","year":"2014","journal-title":"Ultrasound Med Biol"},{"issue":"6","key":"ref10","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1002\/hep.22870","article-title":"Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography","volume":"49","author":"Masuzaki R","year":"2009","journal-title":"Hepatology"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJM199603143341104","article-title":"Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis","volume":"334","author":"Mazzaferro V","year":"1996","journal-title":"N Eng J Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/S0016-5085(19)35759-2","article-title":"An evaluation of the problem of hepatic cirrhosis as seen in S\u00e3o Paulo, Brazil. I. Criteria for classification and incidence","volume":"33","author":"Montenegro MR","year":"1957","journal-title":"Gastroenterology"},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1590\/S0102-67202014000300010","article-title":"Adoption of MELD score increases the number of liver transplant","volume":"27","author":"Nacif LS","year":"2014","journal-title":"Arq Bras Cir Dig"},{"issue":"3","key":"ref14","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1590\/S0102-67202015000300017","article-title":"Late acute rejection in liver transplant: a systematic review","volume":"28","author":"Nacif LS","year":"2015","journal-title":"Arq Bras Cir Dig"},{"issue":"4","key":"ref15","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S1665-2681(19)30845-2","article-title":"Epidemiology of HCC in Brazil: incidence and risk factors in a ten-year cohort","volume":"13","author":"Paranagu\u00e1-Vezozzo DC","year":"2014","journal-title":"Ann Hepatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"3030","DOI":"10.1002\/ijc.21731","article-title":"The global health burden of infection-associated cancer in the year 2002","volume":"118","author":"Parkin DM","year":"2006","journal-title":"Int J Cancer"},{"issue":"4","key":"ref17","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1590\/0102-6720201600040007","article-title":"Liver transplantation for carcinoma hepatocellular in S\u00e3o Paulo: 414 cases by the Milan \/Brazil Criteria","volume":"29","author":"S\u00e1 GP","year":"2016","journal-title":"Arq Bras Cir Dig"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1159\/000315223","article-title":"Epidemiology of hepatocellular carcinoma","volume":"78","author":"Sherman M","year":"2010","journal-title":"Oncology"},{"issue":"Suppl 1","key":"ref19","first-page":"S46","article-title":"Acoustic radiation force impulse elastography as compared to transient Elastography and liver biopsy in patients with chronic hepatopathies","volume":"32","author":"Sporea I","year":"2011","journal-title":"Ultraschall Med"},{"issue":"6","key":"ref20","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1002\/hep.24545","article-title":"Ultrasonographic surveillance of hepatocellular carcinoma in cirrhosis a randomized trial comparing 3- and 6-month periodicities","volume":"54","author":"Trinchet JC","year":"2011","journal-title":"Hepatology"},{"issue":"3","key":"ref21","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1590\/0102-6720201600030014","article-title":"Post-reperfusion liver biopsy and its value in predicting mortality abd graft dysfunction after liver transplantation","volume":"29","author":"Zanchet MV","year":"2016","journal-title":"Arq Bras Cir Dig"},{"issue":"1","key":"ref22","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/hep.20506","article-title":"Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C","volume":"41","author":"Ziol M","year":"2005","journal-title":"Hepatology"}],"container-title":["ABCD. 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