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Resolution of Severe Graft Steatosis Before Living-Donor Liver Transplant After 86 Pounds of Weight Loss
Authors
Roubil, John G.Martins, Paulo N.A.
Babak, Movahedi
Bledsoe, Jacob R.
Bludevich, Bryce M.
Barry, Curtis T.
Bozorgzadeh, Adel
UMass Chan Affiliations
Department of Medicine, Division of GastroenterologyDepartment of Pathology
Department of Surgery, Transplant Division
Document Type
Journal ArticlePublication Date
2020-08-07Keywords
AllocationComplications
Contraindications
Donor selection
Liver transplant
Non-alcoholic fatty liver disease
Digestive System Diseases
Gastroenterology
Surgery
Surgical Procedures, Operative
Metadata
Show full item recordAbstract
Living-donor liver transplant allows for expedited transplant, with outcomes shown to be superior compared with deceased-donor liver transplant due to earlier intervention, with reduced hospital costs. However, they only comprise about 5% of liver transplants nationally. This is due to a limited pool of willing donors and donor exclusions for medical and psycho-social reasons. The leading reason for why potential living liver donors are not eligible is nonalcoholic fatty liver disease. Donor hepatic steatosis limits the number of potential living-donor liver transplants because it is associated with perioperative complications in both donors and recipients. Here, we describe a 37-year-old male potential living donor who presented with hepatic steatosis based on preoperative imaging. Over a 1-year period, he was able to completely reverse his hepatic steatosis by losing about 86 pounds (from 279 to 193 pounds), reducing his body mass index from 40 to 28.55 kg/m(2). Computed tomography and biopsy results after his weight loss showed that he had no hepatic steatosis, allowing him to become a living donor for his mother. Postoperative periods for both the donor and recipient were uncomplicated. This case suggests that the pool of living liver donors could be expanded through dietary and behavior modifications, thus increasing the number of potential living donors and providing potential recipients with more transplant options. Enlarging this pool of donors will also improve transplant outcomes for donors and recipients and lower overall health care costs compared with deceased-donor liver transplant.Source
Roubil JG, Martins PN, Babak M, Bledsoe J, Bludevich BM, Barry C, Bozorgzadeh A. Resolution of Severe Graft Steatosis Before Living-Donor Liver Transplant After 86 Pounds of Weight Loss. Exp Clin Transplant. 2020 Aug 7. doi: 10.6002/ect.2019.0423. Epub ahead of print. PMID: 32778015. Link to article on publisher's site
DOI
10.6002/ect.2019.0423Permanent Link to this Item
http://hdl.handle.net/20.500.14038/41538PubMed ID
32778015Related Resources
ae974a485f413a2113503eed53cd6c53
10.6002/ect.2019.0423