The effect of donor weight reduction on hepatic steatosis for living donor liver transplantation.
Hepatic steatosis is often associated with overweight, so we tried body-weight reduction in potential living donors with fatty liver and/or obesity to alleviate hepatic steatosis. We advised to reducing the body weight by 5% for 9 potential living donors showing hepatic steatosis of 25-95% on initial percutaneous needle biopsy (PCNB). They lost 5.9 +/- 2.0% of the initial body weight during 2-6 months and their body mass index changed from 25.3 +/- 3.8 to 23.7 +/- 3.4. Total amount of hepatic steatosis changed significantly from 48.9 +/- 25.6% to 20.0 +/- 16.2% before and after weight reduction. The proportional reduction in microvesicular steatosis was more obvious than in macrovesicular fatty changes. Six right lobe and 3 left lobe grafts were procured uneventfully from these 9 donors. All donors recovered uneventfully, and all 9 recipients survived more than 15 months to date. In conclusion, we think that short-term weight reduction of living donors will be helpful to alleviate excessive hepatic steatosis, especially in microvesicular type and can contribute to expand the pool of marginal living donors.
Hwang
Shin
S
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Lee
Sung-Gyu
SG
Jang
Se-Jin
SJ
Cho
Sung-Hun
SH
Kim
Ki-Hun
KH
Ahn
Chul-Soo
CS
Moon
Deok-Bog
DB
Ha
Tae-Yong
TY
D001706:Biopsy; D015992:Body Mass Index; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D015431:Weight Loss