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10 January 2020 : Original article  

Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver

Yuki Fujii1BCDEF, Norio Kawamura2ADE, Masaaki Zaitsu1BE, Masaaki Watanabe2DE, Ryoichi Goto1BDE, Toshiya Kamiyama1BD, Akinobu Taketomi1DE, Tsuyoshi Shimamura3ADE*

DOI: 10.12659/AOT.920677

Ann Transplant 2020; 25:e920677


BACKGROUND: The aim of this study was to determine the efficacy of treating donors’ fatty liver (FL) and to assess early graft function in recipients who received treated FL grafts in living-donor liver transplantation (LDLT).

MATERIAL AND METHODS: Data were collected for adult-to-adult LDLTs. Donors diagnosed with FL (FL group) received diet–exercise and pharmacological treatment. The perioperative findings and early transplanted graft function were compared with those of donors without FL (non-FL group) during the same period.

RESULTS: Of 30 donors, 8 were determined to have FL. The median duration of treatment for FL was 58 days. The liver-to-spleen attenuation ratios on CT scan in the FL group were significantly improved after treatment: 0.95 (0.62–1.06) to 1.2 (1.12–1.46) (P=0.003). Liver biopsy prior to donor surgery showed ≤10% fatty infiltration. Postoperative laboratory findings of the donors in the FL group were comparable to those in the non-FL group: maximum alanine transaminase (189.6±94.7 IU/L vs. 196.8±57.4) and maximum total bilirubin (2.2±1.1 mg/dL vs. 1.7±0.5 mg/dL). No major complications were observed after donor hepatectomy in either group. There were no significant differences between the 2 groups in early graft function, as evaluated by laboratory data, ascites volume, and bile production 2 weeks postoperatively. Graft and patient survival were 100% in both groups at 3 months.

CONCLUSIONS: Preoperative intentional treatment for FL was effective. Early graft function and donor postoperative course were comparable in the 2 groups. These results suggest that well-treated steatotic grafts can be used without jeopardizing donor safety.

Keywords: Diet Therapy, Fatty Liver, Liver Transplantation, Living Donors, Adolescent, Graft Survival, Hepatectomy, Postoperative Period, young adult

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358