Steatosis Among Living Liver Donors Without Evidence of... : Transplantation (original) (raw)

Clinical and Translational Research

Steatosis Among Living Liver Donors Without Evidence of Fatty Liver on Ultrasonography

Potential Implications for Preoperative Liver Biopsy

Ahn, Joon Seong; Sinn, Dong Hyun; Gwak, Geum-Youn; Kim, Jong Man; Kwon, Choon Hyuck; Joh, Jae Won; Paik, Yong-Han; Choi, Moon Seok; Lee, Joon Hyeok; Koh, Kwang Cheol; Paik, Seung Woon; Yoo, Byung Chul

1 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

2 Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea.

3 Division of Transplantation Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

4 Address correspondence to: Geum-Youn Gwak, M.D., Ph.D., Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea.

The authors declare no funding or conflicts of interest.

E-mail: [email protected]

J.S.A. and D.H.S. contributed equally to this study. J.S.A. participated in the data collection, data analysis, and preparation of the article. D.H.S. participated in the study concept and design, preparation of the article. G.-Y.G. participated in the study concept and design and critical revision of the article. J.M.K., C.H.K., and J.W.J. participated in the data collection and analysis. Y.-H.P., M.S.C., J.H.L., K.C.K., S.W.P., and B.C.Y. provided the data and participated in the critical revision of the article for important intellectual content. All authors have approved the final submission.

Received 2 January 2013. Revision requested 23 January 2013.

Accepted 12 February 2013.

Abstract

Background

The degree of steatosis is an important factor that determines the graft function in the recipient and the recovery of the remnant liver in the living donor. To date, there is no consensus regarding how to assess steatosis among potential living liver donors. We evaluate the prevalence and risk factors for steatosis in living liver donors with normal serum aminotransferase levels and without fatty liver on ultrasonography (US-negative).

Methods

The degree of steatosis was assessed for a total of 492 US-negative living liver donors with normal aminotransferase levels (age 30.1±9.9; male 301 [61.2%]). Total steatosis was defined by adding the degree of macrosteatosis and microsteatosis.

Results

No liver donor had a severe degree (≥60%) of macrosteatosis or microsteatosis. A moderate degree (30–59%) of macrosteatosis and microsteatosis was seen in 4 (0.8%) and 26 (5.3%) subjects, respectively. Severe and moderate degrees of total steatosis were seen in 3 (0.6%) and 53 (10.8%) subjects, respectively. Body mass index and serum triglyceride levels were independent factors associated with the moderate or greater degree of total steatosis.

Conclusions

Noninvasive preoperative assessment for liver steatosis (US-negative with normal aminotransferase level) was sufficient to exclude severe macrosteatosis or microsteatosis and moderate macrosteatosis but not sufficient to exclude moderate microsteatosis or total steatosis in living liver donors.