title: Rapid Reversal of Liver Steatosis With Life Style Modification in Highly Motivated Liver Donors.
abstract: BACKGROUND
  Liver steatosis is the leading cause of donor rejection in living donor liver transplantation. Rapid weight loss is difficult to achieve in a short period of time, moreover it has been thought to worsen liver histology.
  
  
  METHODS
  Donors who had significant steatosis based on liver biopsy were recommended 1200 Kcal/day and a minimum of 60 min/day moderate cardio training. Two patients were advised statins for dyslipidemia. None of the donors had metabolic syndrome. A second ultrasound guided liver biopsy was done at 28 ± 10 days. Donors with nonalcoholic steatohepatitis/fibrosis or >30% steatosis were not included.
  
  
  RESULTS
  From July 2010 to January 2015, 16 donors were advised aggressive life style modification after initial biopsy; 15 (10 males, age 27.5 ± 6.5 years, baseline body mass index 28.4 ± 2.1 Kg/M(2)) successfully reduced weight and 14 underwent donation after favorable second biopsy. Mean weight loss was 7 ± 4.3 kg (8.4 ± 4.6%). Second liver biopsy was done at 28 ± 10 days, there was decrease in steatosis in all but one including normalization of liver biopsy in 7 donors. Three donors had mild inflammation on first biopsy and they had improvement in second biopsy. All the donors and their recipients had an uneventful post-operative course.
  
  
  CONCLUSIONS
  Steatosis can be reversed in a short duration by aggressive life style modifications in highly motivated liver donors.
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Narendra S
authors.initials: NS
authors.lastname: Choudhary
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saraf
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Saigal
authors.affiliation: Department of Histopathology, Medanta, The Medicity, Gurgaon, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Gautam
authors.affiliation: Department of Histopathology, Medanta, The Medicity, Gurgaon, India.
authors.forename: Lipika
authors.initials: L
authors.lastname: Lipi
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Rastogi
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Goja
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Palat B
authors.initials: PB
authors.lastname: Menon
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Bhangui
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Sumana K
authors.initials: SK
authors.lastname: Ramchandra
authors.affiliation: Medanta Liver Institute, Medanta, The Medicity, Gurgaon, India.
authors.forename: Arvinder S
authors.initials: AS
authors.lastname: Soin
keywords: ALT, alanine transaminase; ALT, aspartate transaminase; BMI, body mass index; LAI, liver attenuation index; LDLT, living donor liver transplantation; NAFLD, non-alcoholic fatty liver disease; diet; donor; exercise; life style modification; liver biopsy