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.