title: Ultrasonic integrated backscatter in assessing liver steatosis before and after liver transplantation.
abstract: BACKGROUND
  Liver steatosis affects 20%-30% of adults. Because of the increasing gap between graft supplies and demands, livers with steatosis are frequently used in liver transplantation. But severely steatotic liver grafts are associated with a high risk of intraoperative and postoperative complications. Accurate assessment of fat content of donor livers and monitoring of the extent of steatosis in recipients are required for liver transplantation. The present study aimed to determine the correlation between liver echogenicity and fat content, and to evaluate the use of an ultrasonic integrated backscatter system (IBS) in the assessment of changes in fat content after liver transplantation.
  
  
  METHODS
  Seventy-nine consecutive patients receiving liver grafts from living donors were evaluated in our center. Of these recipients, 67 survived for more than two years and were included in this study. Each liver graft was evaluated with IBS and ultrasound before operation and the fat content was estimated. The fat content of the grafts in the recipients was again assessed with ultrasound at 18 months after surgery.
  
  
  RESULTS
  A correlation was detected between each graft's IBS value and its fat content (P=0.001). The IBS value in fatty grafts with various degrees of steatosis was significantly decreased in 3 (P=0.02), 12, 15 and 18 (P=0.001) months after orthotopic liver transplantation. The IBS value returned to normal in all patients in 18 months after liver transplantation.
  
  
  CONCLUSIONS
  Decreased fat content in steatotic grafts can be observed in all recipients. Ultrasonic IBS is useful in determining the steatotic degree of grafts in donors as well as in monitoring the grafts after liver transplantation.
authors.affiliation: Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, China. cdlibo@medmail.com.cn.
authors.forename: Han-Teng
authors.initials: HT
authors.lastname: Yang
authors.forename: Ke-Fei
authors.initials: KF
authors.lastname: Chen
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lu
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Wei
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Yang
authors.initials: Y
authors.lastname: Qin
authors.forename: Wen-Qing
authors.initials: WQ
authors.lastname: Huang
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D046148:Donor Selection; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult