Use of Transient Elastography to Guide Immunosuppression Minimization After Liver Transplantation

What this Trial Is About

Researchers are evaluating the use of transient elastography (FibroScan), a non-invasive ultrasound tool that measures liver stiffness and fat content, to guide the reduction of immunosuppression in stable liver transplant recipients. Long-term immunosuppression after liver transplantation can cause side effects such as kidney problems, diabetes, heart disease, and increased cancer risk. This study aims to see if FibroScan can help safely minimize immunosuppression, especially in individuals without autoimmune liver disease or recent rejection episodes. Participants will be randomly assigned to either continue standard care or undergo immunosuppression reduction guided by FibroScan results. For those with liver stiffness measurement (LSM) below 8.4 kPa, immunosuppression will be gradually reduced by about 30% over three months. These patients will have FibroScan assessments at 4, 7, and 12 months after reduction, along with frequent liver blood tests to monitor liver health and ensure no rejection occurs. During the study, participants will have liver function tests every two weeks for the first four months, then monthly afterward. Researchers will track the number of patients who successfully reduce immunosuppression without rejection over six months. Secondary goals include assessing effects on kidney function, metabolic syndrome, heart disease risk factors, cancer, and overall graft and patient survival. The total duration of follow-up varies with monitoring extending up to at least one year after immunosuppression reduction.

Fibroscan to Guide Post Transplant Immunosuppression Minimization