Liver Graft and Spleen Elastography After Living Liver Transplantation: Our First Results Nuru Bayramov a , Sezai Yilmaz b , Sevinj Salahova a, *, Adil Bashkiran b , Nadir Zeynalov a , Elvin Isazade a , and Terane Bayramova c a Surgical Diseases Department, Azerbaijan Medical University, Baku, Azerbaijan; b Turgut Ozal Medical Center, Inonu University School of Medicine, Malatya, Turkey; and c Obstetric-Gynecology Department, The Central Customs Hospital, Baku, Azerbaijan ABSTRACT Aim of the study. Liver transplantation is widely applied as a standard and effective management of end-stage liver diseases, hepatocellular carcinoma, and acute liver failure. Investigation of morphologic and functional changes in the transplanted graft, gastrointestinal system, and spleen after transplantation is an important ground for assessment of post-transplantation results, early changes related to complications, and evaluation of response to treatment modalities. The aim of this study was to investigate the dynamics of changes in elastography of the liver graft and spleen after living-related liver transplantation. Material and methods. The study included 14 cirrhotic patients after living-related liver graft transplantation. Stiffness of the spleen and liver was evaluated before transplantation and at 1, 3, and 6 months after transplantation with a Supersonic Aixplorer Multi Wave device. Each procedure consisted of measuring the density in 10 points (spots) of the organ. The final result was calculated as the mean value of successful measurements (must have been > 60% of all measurements) and expressed in kilopascals. Results. The mean value of the liver and spleen stiffness before transplantation was 27 kPa (14e31 kPa) and 51 kPa (38e92 kPa), respectively. The stiffness of the spleen gradually reduced after transplantation to 40.3, 35.4, and 24.1 kPa (P ¼ .001) at 1, 3, and 6 months. The stiffness of the liver graft in patients without complications was stable at 4e5 kPa, whereas the same value in patients with complications was increased ( 7.5 kPa). In 5 patients, endoscopic investigation confirmed the significant reduction of varicose veins after surgery. Conclusion. Elastography of the liver graft and spleen after liver transplantation can be recommended as a useful-for-patient 1-off method of investigation. L IVER transplantation is widely applied as a standard and effective management of end-stage liver diseases, hepatocellular carcinoma, and acute liver failure. Investi- gation of morphologic and functional changes in the transplanted graft, gastrointestinal system, and spleen after transplantation is an important ground for assess- ment of post-transplantation results, early changes related to complications, and evaluation of response to treatment modalities. Ultrasound-based elastography nowadays replaces palpation, and differently from it, elastography is an objective, tangible, and countable method, which is widely applied in liver pathologies for detection of fibrosis, portal hypertension, and complications [1,2]. Spleen elastography This study has been carried out with the support of the Science Development Foundation, under the President of the Republic of Azerbaijan. *Address correspondence to Sevinj Salahova, Azerbaijan Medical University, A. Gasimzade St 14, Postal Code AZ 1022, Baku, Azerbaijan. Tel: þ994 503151717. E-mail: salahovaseva@ yahoo.com 0041-1345/19 https://doi.org/10.1016/j.transproceed.2019.01.184 ª 2019 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169 2446 Transplantation Proceedings, 51, 2446e2450 (2019)