Nonalcoholic steatohepatitis in donors for living donor liver transplantation.
BACKGROUND
In 2003, we encountered the first donor death for living donor liver transplantation in Japan, which was related to nonalcoholic steatohepatitis (NASH). The aim of this study was to retrospectively investigate the prevalence of NASH among a living donor liver transplantation donor population and to analyze the postoperative course for both donors and recipients of NASH grafts to minimize risk for donors.


METHODS
The study population comprised 263 donors who donated the right lobe of the liver between February 1998 and April 2003. Their zero-hour biopsy specimens were screened retrospectively. Regarding severe steatosis or NASH, long-term follow-up results for laboratory data from donors were investigated along with changes in graft histologic findings in recipients.


RESULTS
NASH was diagnosed histopathologically in three cases (1.1%). Pathologic examination showed that a donor who died in 2003 had the most severe NASH among the three cases. The remaining two NASH donors had uneventful postoperative courses without complications. All grafts showed improvement with respect to the steatosis and histologic findings of NASH.


CONCLUSIONS
Donor safety is a top priority in living donor liver transplantation. To exclude patients with NASH from potential donor lists, careful evaluation, including selective preoperative liver biopsy, should be carried out.
Yamamoto
Koji
K
Department of Transplantation and Immunology, Faculty of Medicine, Kyoto University, Kyoto, Japan.
Takada
Yasutsugu
Y
Fujimoto
Yasuhiro
Y
Haga
Hironori
H
Oike
Fumitaka
F
Kobayashi
Nobuaki
N
Tanaka
Koichi
K
D000328:Adult; D005234:Fatty Liver / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies