Molecular and cellular markers of subclinical graft fibrosis after pediatric liver transplantation and non-invasive assessment of liver fibrosis

Silja Helena Voutilainen

Research output: ThesisDoctoral ThesisCollection of Articles


Subclinical fibrosis and inflammation are common findings in pediatric hepatic diseases and in liver grafts after liver transplantation (LT). The mechanisms of these histopathological changes are unclear. Biomarkers that would precede these changes and non-invasive ways to assess fibrosis are needed. The aim of this thesis was to investigate the molecular and cellular markers of subclinical graft fibrosis and non-invasive methods to determine the stage of fibrosis and varices. Study I included 99 pediatric patients with chronic liver disease who underwent liver biopsy sampling for histology and transient elastography (TE) study for liver stiffness (LS) between January 2012 to March 2015. In addition, data on spleen size, platelet count, and aspartate aminotransferase to platelet ratio index (APRI) were collected. Esophagogastroduodenoscopy (EGD) was performed for 61 patients to assess varices. LS had the best accuracy in the prediction of liver fibrosis stage, compared to APRI, spleen size, and platelets to spleen size score. For moderate fibrosis (≥F2) and cirrhosis (F4) the area under receiver curve (AUROC) values for LS were 0.831 (95%CI: 0.745-0.981, p
Original languageEnglish
  • Pakarinen, Mikko Petteri, Supervisor
  • Jalanko, Hannu J, Supervisor
Place of PublicationHelsinki
Print ISBNs978-951-51-7195-5
Electronic ISBNs978-951-51-7196-2
Publication statusPublished - 2021
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 92 s. + liitteet

Fields of Science

  • 3123 Gynaecology and paediatrics

Cite this