Ahmed Swelam1,2, René Adam1,3,4, Lelde Lauka1, Luiza Basilio Rodrigues1, Sherif Elgarf1,2, Mylène Sebagh1,5, Nicolas Golse1,5, Antonio Sa Cunha1,3,4, Daniel Cherqui1,5,4, Denis Castaing1,5,4, Marc-Antoine Allard6,7,8. 1. AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 12 av Paul Vaillant Couturier, 94804, Villejuif Cedex, France. 2. Gastrointestinal and HPB Surgery Department, Tanta University Hospital, Tanta, Egypt. 3. Unités Mixtes de Recherche en Santé 935, INSERM, Villejuif, France. 4. Université Paris-Sud, Faculté de Médecine, Le Kremlin-Bicêtre, France. 5. Unités Mixtes de Recherche en Santé 1193, INSERM, Villejuif, France. 6. AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 12 av Paul Vaillant Couturier, 94804, Villejuif Cedex, France. marcantoineallard@yahoo.fr. 7. Unités Mixtes de Recherche en Santé 935, INSERM, Villejuif, France. marcantoineallard@yahoo.fr. 8. Université Paris-Sud, Faculté de Médecine, Le Kremlin-Bicêtre, France. marcantoineallard@yahoo.fr.
Abstract
BACKGROUND AND AIMS: Assessing the risk of significant macrosteatosis in donors is crucial before considering hepatic graft procurement. We aimed to build a model to predict significant macrosteatosis based on noninvasive methods. METHODS: From January 2012 to December 2018, liver attenuation indices and liver-to-spleen (L/S) ratio were measured in 639 brain-dead donors by local radiologists. Quantity and quality of steatosis were evaluated by an expert pathologist, blinded for attenuation indices measurement. RESULTS: Macrosteatosis ≥ 30% was found in 33 donors (5.2%). Body weight, body mass index (BMI), abdominal perimeters, history of alcohol abuse, L/S ratio, and liver parenchyma attenuation were associated with macrosteatosis ≥ 30%. The L/S ratio, BMI, and a history of alcohol abuse remained independent predictors in multivariate analysis and were used to build a predictive model (C-index: 0.77). The optimal cutoff to predict macrosteatosis ≥ 60% was 0.85. CONCLUSION: Our model, including L/S ratio, BMI, and history of alcohol, might be helpful to refine indication for liver biopsy before donation after brain death. External validation is required.
BACKGROUND AND AIMS: Assessing the risk of significant macrosteatosis in donors is crucial before considering hepatic graft procurement. We aimed to build a model to predict significant macrosteatosis based on noninvasive methods. METHODS: From January 2012 to December 2018, liver attenuation indices and liver-to-spleen (L/S) ratio were measured in 639 brain-dead donors by local radiologists. Quantity and quality of steatosis were evaluated by an expert pathologist, blinded for attenuation indices measurement. RESULTS: Macrosteatosis ≥ 30% was found in 33 donors (5.2%). Body weight, body mass index (BMI), abdominal perimeters, history of alcohol abuse, L/S ratio, and liver parenchyma attenuation were associated with macrosteatosis ≥ 30%. The L/S ratio, BMI, and a history of alcohol abuse remained independent predictors in multivariate analysis and were used to build a predictive model (C-index: 0.77). The optimal cutoff to predict macrosteatosis ≥ 60% was 0.85. CONCLUSION: Our model, including L/S ratio, BMI, and history of alcohol, might be helpful to refine indication for liver biopsy before donation after brain death. External validation is required.
Authors: M A Ureña; F C Ruiz-Delgado; E M González; C L Segurola; C J Romero; I G García; I González-Pinto; R Gómez Sanz Journal: Transplant Proc Date: 1998-11 Impact factor: 1.066
Authors: Michael S Middleton; Elhamy R Heba; Catherine A Hooker; Mustafa R Bashir; Kathryn J Fowler; Kumar Sandrasegaran; Elizabeth M Brunt; David E Kleiner; Edward Doo; Mark L Van Natta; Joel E Lavine; Brent A Neuschwander-Tetri; Arun Sanyal; Rohit Loomba; Claude B Sirlin Journal: Gastroenterology Date: 2017-06-15 Impact factor: 22.682
Authors: Lulu Sun; Jon N Marsh; Matthew K Matlock; Ling Chen; Joseph P Gaut; Elizabeth M Brunt; S Joshua Swamidass; Ta-Chiang Liu Journal: EBioMedicine Date: 2020-09-24 Impact factor: 8.143