Background & Aims: Hepatic fibrosis is an important predictor of liver- and non-liver related outcomes in patients with chronic liver disease (CLD) and liver transplantation recipients (LTR). Several non-invasive models have been developed to stage fibrosis but their accuracy in LTR is unknown. The aim of the current study was to evaluate the accuracy of non-invasive models in differentiating advanced fibrosis (≥F3) from earlier fibrosis stages among patients with nonalcoholic fatty liver disease (NAFLD) and hepatitis C (HCV) in the LTR and non-transplant cohorts.

Methods: This was a retrospective study comparing accuracy of non-invasive models of fibrosis to liver biopsy. Models were constructed using data within 8 weeks of liver biopsy. Areas under the receiver operator curves (AUROC), sensitivity, specificity, positive predictive value, and negative predictive values were compared. Optimal cut-off values maximizing specificity and sensitivity were determined using Youden Index.

Results: In non-transplant population, FIB4 (AUROC: 0.887), NAFLD fibrosis score (0.826) and APRI (0.810) had high accuracy for detecting advanced fibrosis (≥F3) in NAFLD, while FIB4 (0.831) and Kings Score (0.820) outperformed other models for detecting ≥F3 in HCV cohort. In contrast, the diagnostic accuracy of all non-invasive models were worse in LTR despite optimizing cutoff values specific to the liver transplantation population. However, the NPV for these models in LTR was high in patients with recurrence of NAFLD and HCV after liver transplantation.

Conclusion:Non-Invasive fibrosis have high accuracy for detecting advanced fibrosis in non-transplant patients with hepatitis C and NAFLD. The diagnostic performance is for non-invasive fibrosis models is lower in liver transplant recipients. The NPV for non-invasive fibrosis models in LTR is high, thus they can be used to exclude patients in whom invasive evaluation may not be necessary.

CITATION INFORMATION: Galvez D., Bhati C., Siddiqui M., Schmoyer C., Arshad T., Sharma A., Cotterell A., Yadav K., Reichman T., Levy M. Diagnostic Accuracy of Non-Invasive Test of Hepatic Fibrosis in Liver Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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