Allograft fibrosis is increasingly detected in graft biopsies as the postoperative period extends, potentially emerging as a pivotal determinant of long-term graft function and graft survival among pediatric recipients. Currently, there is a paucity of noninvasive diagnostic tools capable of identifying allograft fibrosis in pediatric recipients of liver transplants. This study involved 507 pediatric liver transplant patients and developed a novel blood-based diagnostic assay, Pediatric Liver Transplantation-Liver Fibrosis Evaluation (PT-LIFE), to noninvasively distinguish allograft fibrosis using blood samples, clinical data, and biopsy outcomes. The PT-LIFE assay was derived from a matrix of 23 variables and validated in 2 independent cohorts. It integrates 3 biomarkers (LECT2, YKL-40, FBLN3) with an area under the receiver operating characteristic curve of 0.91. In the pooled analysis, a PT-LIFE score lower than 0.12 identified liver allograft fibrosis semiquantitative scores 0 to 2 with a sensitivity of 91.9%, whereas scores above 0.29 indicated liver allograft fibrosis semiquantitative scores 3 to 6, with a specificity of 88.4%. The PT-LIFE assay presents as a promising noninvasive diagnostic tool for the detection of allograft fibrosis in pediatric liver transplant recipients.

中文翻译：

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用于肝移植后小儿肝纤维化无创评估的基于血液的 PT-LIFE（小儿肝移植-肝纤维化评估）生物标志物组：一项前瞻性推导和验证研究


随着术后时间的延长，移植物活检中越来越多地检测到同种异体移植物纤维化，可能成为儿科受者长期移植物功能和移植物存活的关键决定因素。目前，缺乏能够识别肝移植儿科受者同种异体移植纤维化的无创诊断工具。这项研究涉及 507 名儿科肝移植患者，并开发了一种新的基于血液的诊断检测方法，即儿科肝移植-肝纤维化评估 （PT-LIFE），以使用血液样本、临床数据和活检结果无创区分同种异体移植物纤维化。PT-LIFE 测定源自 23 个变量的矩阵，并在 2 个独立队列中进行了验证。它整合了 3 个生物标志物 （LECT2、YKL-40、FBLN3），受试者工作特征曲线下面积为 0.91。在汇总分析中，PT-LIFE 评分低于 0.12 确定肝同种异体移植物纤维化半定量评分为 0 至 2 分，敏感性为 91.9%，而高于 0.29 分表明肝同种异体移植物纤维化半定量评分为 3 至 6 分，特异性为 88.4%。PT-LIFE 检测是一种很有前途的无创诊断工具，用于检测儿科肝移植受者同种异体移植物纤维化。