Hepatic Pathologic Change After Donor Weight Reduction in Potential Living Liver Donors With Fatty Liver.

Abstract

Background Fatty liver is critical for donor selection, which has been associated with a risk of complication for both donor and recipient after liver transplantation. After living donor weight reduction for a short-term, the change of liver fat percentile and pathologic findings were investigated. Methods A total of 356 living donor candidate were between January 2011 and November 2013 at a single center. Of them, 18 donors tried to lose their weight reduction. Fat fraction was estimated on preoperative non-invasive MR spectroscopy. And liver biopsy findings were analyzed before and after weight reduction. Results Eighteen donor candidates lose mean 3.6 ± 3.1 kg of their weight for mean 43.9 ± 31.0 days (range 7-107 days) and BMI was significantly decreased to 25.9 ± 3.1 kg/m2 from 27.1 ± 3.2 kg/m2 (p < 0.001). Their fat fractions were also significantly decreased to 6.8 ± 4.5% from 11.4 ± 4.7% (p < 0.001). Although preoperative liver biopsy showed that ballooning change (n=3, 23.1%), inflammation (n=9, 69.2%), fibrosis (n=2, 15.4%) and necrosis (n=3, 16.7%) before weight reduction, intraoperative biopsy showed no fibrosis, no necrosis, decreased inflammation (n=2, 17.6%) and improved ballooning change of hepatocyte (n=1, 5.9%) after weight reduction.Table: No Caption available.Although one candidate could not donate his liver finally because of steatohepatitis, the others recovered uneventfully. Conclusions Donor body weight reduction can expand donor pool and contribute to donor safety.