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    Resolution of Severe Graft Steatosis Before Living-Donor Liver Transplant After 86 Pounds of Weight Loss

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    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 Gastroenterology
    Department of Pathology
    Department of Surgery, Transplant Division
    Document Type
    Journal Article
    Publication Date
    2020-08-07
    Keywords
    Allocation
    Complications
    Contraindications
    Donor selection
    Liver transplant
    Non-alcoholic fatty liver disease
    Digestive System Diseases
    Gastroenterology
    Surgery
    Surgical Procedures, Operative
    
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    Link to Full Text
    https://doi.org/10.6002/ect.2019.0423
    Abstract
    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.2019.0423
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/41538
    PubMed ID
    32778015
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.6002/ect.2019.0423
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