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. CONCLUSION: Steatosis can be reversed in a short duration by aggressive life style modifications in highly motivated liver donors.
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. CONCLUSION:Steatosis can be reversed in a short duration by aggressive life style modifications in highly motivated liver donors.
Entities:
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
Authors: Carlos K Furuya; Claudia P M S de Oliveira; Evandro S de Mello; Joel Faintuch; Alessandra Raskovski; Mitsunori Matsuda; Denise C P Vezozzo; Alfredo Halpern; Arthur B Garrido; Venâncio A F Alves; Flair J Carrilho Journal: J Gastroenterol Hepatol Date: 2007-04 Impact factor: 4.029
Authors: Samer G Mattar; Laura M Velcu; Mordechai Rabinovitz; A J Demetris; A M Krasinskas; Emma Barinas-Mitchell; George M Eid; Ramesh Ramanathan; Debra S Taylor; Philip R Schauer Journal: Ann Surg Date: 2005-10 Impact factor: 12.969
Authors: Piyaporn Limanond; Steven S Raman; Charles Lassman; James Sayre; R Mark Ghobrial; Ronald W Busuttil; Sammy Saab; David S K Lu Journal: Radiology Date: 2004-01 Impact factor: 11.105
Authors: Jonathan M Hazlehurst; Conor Woods; Thomas Marjot; Jeremy F Cobbold; Jeremy W Tomlinson Journal: Metabolism Date: 2016-01-11 Impact factor: 8.694
Authors: D Osipova; K Kokoreva; L Lazebnik; E Golovanova; Ch Pavlov; A Dukhanin; S Orlova; K Starostin Journal: Front Pharmacol Date: 2022-03-10 Impact factor: 5.810
Authors: John T Rose; Paola Vargas; Tara Seay; Arthur J Pesch; Tessa Williams; Anita Sites; Zachary Henry; Patrick G Northup; Shawn J Pelletier; Jose Oberholzer; Curtis K Argo; Nicolas Goldaracena Journal: Transplant Direct Date: 2021-05-25