To investigate the clinical value of shear wave elastography (SWE) combined with conventional ultrasound in the evaluation of donor liver quality.

From February 2014 to October 2017, 121 cases of donation after citizens′ death for liver transplantation were performed in Calmette Hospital Affiliated to Kunming Medical University, and all the donors were performed with ultrasound and SWE before the graft harvest. The donors were divided into normal group and abnormal group according to the intraoperative rapid pathological results. The abnormal group included fatty liver, liver fibrosis, liver congestion and liver necrosis. The group t test was used to compare the Young′s modulus between abnormal group, fatty liver group, liver fibrosis group and normal group. The area under the ROC curve was calculated. The Young′s modulus at the highest Youden index was used as the cut-off value to distinguish between normal and abnormal donor livers, and the corresponding sensitivity and specificity were calculated.

There were 73 cases in normal group and 48 cases in abnormal group (21 cases of fatty liver, 18 cases of liver congestion, 5 cases of liver fibrosis, and 4 cases of liver necrosis) according to the results of intraoperative rapid pathological examination. The Young′s modulus of donor livers in abnormal group and normal group were (5.55±1.56) kPa and (3.64±0.70) kPa, respectively, with significant difference (t=7.964, P<0.05). When the cut-off value was 4.07 kPa, the Youden index was 0.628, which was the highest, and the sensitivity and specificity of SWE in the diagnosis of donor liver lesions were 83.3% and 79.5%, respectively. The Young′s modulus of fatty liver group and liver fibrosis group were (5.56±1.43) and (6.67±1.36) kPa, both of them were higher than that of normal group (t=5.974 and 4.933, P all<0.05). The range of Young′s modulus was (2.46-7.11) kPa and (5.62-9.11) kPa in liver congestion group and liver necrosis group, respectively.

SWE can quantitatively evaluate the hardness of liver tissue, and has a high specificity in the differentiation of abnormal and normal donor livers. SWE combined with conventional ultrasound can evaluate the quality of donor liver noninvasively and quantitatively, which has high clinical application value.