title: Prediction of nonalcoholic fatty liver in prospective liver donors.
abstract: Metabolic risk factors should be important in addition to imaging for prediction of steatosis in prospective liver donors.
  
  
  
  The study group included all prospective liver donors who had a liver biopsy during workup. Risk factors of metabolic syndrome were analyzed, and body mass index (BMI) ≥25 kg/m2was used in place of waist circumference. Three BMI cutoffs (25, 28, and 30 kg/m2) and two CT-measured liver attenuation index (LAI) cutoffs (<5 and ≤10) were used for steatosis assessment of ≥5%, ≥10%, and ≥20%.
  
  
  
  Of the 573 prospective donors (307 females), 282 (49.2%) donors had nonalcoholic fatty liver (NAFL). When donors with NAFL were compared with donors having normal histology, multivariate analysis showed BMI, ALT, triglycerides, and LAI as significant predictors of NAFL. BMI ≥25 kg/m2and LAI <10 were better cutoffs. The presence of ≥2 metabolic risk factors had better sensitivity than CT-LAI for the presence of NAFL and ≥20% steatosis (58% and 54% vs 47% and 22%, respectively, for CT-LAI ≤10). The presence of LAI >10 and <2 metabolic risk factors predicted <10% steatosis with 96% specificity and 92% positive predictive value.
  
  
  
  The presence of ≥2 metabolic risk factors improves sensitivity of CT-LAI for prediction of donor steatosis.
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, India.
authors.forename: Narendra S
authors.identifier: 0000-0002-4387-0036
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 Hepatology, Post Graduate Institute of Medical Education and Research, Medanta The Medicity, Gurgaon, Chandigarh, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Duseja
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: 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: Yalakanti Raghavendra
authors.initials: YR
authors.lastname: Babu
authors.affiliation: Medanta Liver Institute, Medanta The Medicity, Gurgaon, India.
authors.forename: Arvinder S
authors.initials: AS
authors.lastname: Soin
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D019520:Living Donors; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: donor; histology; liver transplantation; metabolic syndrome; steatosis