Magnetic resonance imaging‐derived proton density fat fraction (MRI‐PDFF) is a viable alternative to liver biopsy for steatosis quantification in living liver donor transplantation

Qi, Qiaochu; Weinstock, Allison K.; Chupetlovska, Kalina; Borhani, Amir A.; Jorgensen, Dana; Furlan, Alessandro; Behari, Jaideep; Molinari, Michele; Ganesh, Swaytha; Humar, Abhinav; Duarte‐Rojo, Andrés

doi:10.1111/ctr.14339

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…This may have been due to a significant proportion of nondonors still awaiting transplant at the time of analysis, as a previous study of 151 donors conducted at our institution found lower steatosis grade on MRI-PDFF in donors than nondonors. 36 As previously reported, 44 we did not find any improved accuracy of CAP when restricting analysis to determinations with a CAP IQR above or below 40 dB/m (or with 30 dB/m; data not shown), confirming that this previously proposed quality metric can be obviated. 32 One of the major strengths of our study involves using novel L-GrAFT risk scores to define early allograft dysfunction.…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, despite excellent donor and recipient outcomes at our own institution, we previously reported a high incidence of coagulopathy during the first week post-transplant leading to rates of EAD up to 36%. 30,36 Unexpectedly, L-GrAFT did not correlate with CAP or MRI-PDFF likely in relation to the small sample and selection bias inherent to the LLD approval process.…”

Section: Discussionmentioning

confidence: 94%

“…We previously showed that in MRI-PDFF up to 20%, liver regeneration in LLD is not affected, and such degree of steatosis (which corresponds to macrosteatosis of approximately 33% by histopathology) does not impact recipient outcomes. 36 For hepatic fat quantification, MRI-PDFF has emerged as a validated surrogate to liver biopsy and the noninvasive modality of choice, due to its accurate, reproducible nature with minimal sampling variation. [8][9][10][11]37 It has already been used as the standard of reference in numerous studies.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of hepatic steatosis using controlled attenuation parameter and MRI‐derived proton density fat fraction in living donor liver transplantation

Zhuang

Weinstock

Ganesh

et al. 2022

Clinical Transplantation

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Background:The increasingly favorable outcomes of live donor liver transplant warrant development of screening techniques to expand current donor pool. Transient elastography (TE) with controlled attenuation parameter (CAP) is accessible and has promising diagnostic performance in non-obese individuals. Here, we demonstrate its utility in grading donor steatosis for risk assessment in living liver donors (LLD). Study Design:In a prospective study of LLD and recipients, accuracy was determined using MRI-derived proton density fat fraction (PDFF) as reference.Results: One hundred and one LLD underwent TE, 95 of whom had available PDFF.Median CAP and MRI-PDFF were 233 dB/m (206-270) and 2.9% (2.3-4.0), respectively. A CAP threshold of 270 dB/m captured all steatosis which was present in 13 (13%) LLD (AUROC .942, 100% sensitivity and 83% specificity). Performance further improved when excluding obese LLD and limiting analysis to M-probe (AUROC .971 and .974, respectively, with 87% specificity). There was no difference in CAP and MRI-PDFF between LLD and nondonors (P = .26 and .21, respectively). Early allograft dysfunction was observed in one recipient (CAP 316, PDFF 9.5%), zero underwent retransplant, and one died from sepsis. Conclusion:The specific role of CAP in living liver donation warrants further study, beginning with its use as screening tool across peripheral clinics.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Characterization of hepatic steatosis using controlled attenuation parameter and MRI‐derived proton density fat fraction in living donor liver transplantation

Zhuang

Weinstock

Ganesh

et al. 2022

Clinical Transplantation

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“…Future studies leveraging noninvasive steatosis measurements (eg, MR spectroscopy) could also evaluate steatosis as an effect modifier of increasing donor age on outcomes. [25][26][27] Interestingly, there were differences in the donor-recipient relationship noted. Donors >55 y were more often nonbiological, potentially reflecting the unavailability or unsuitability of younger biologically-related donors.…”

Section: Discussionmentioning

confidence: 99%

Impact of Older Donor Age on Recipient and Graft Survival After LDLT: The US Experience

2022

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Background. The impact of selecting older donors for living donor liver transplantation (LDLT) in the United States is incompletely studied, particularly in light of the recent expansion of LDLT nationally. Methods. Adult LDLTs from January 01, 2005 to December 31, 2019 were identified using the United Network for Organ Sharing database. Multivariable Cox models evaluated living donor (LD) age as a predictor of LDLT recipient and graft survival. The impact of increasing donor age on recipient outcomes was compared between LD and deceased donor recipients. Donor postoperative outcomes were evaluated. Results. There were 3539 LDLTs at 65 transplant centers during the study period. Despite the recent expansion of LDLT, the proportion of LDs aged ≥50 y was stable. There were no clinically significant differences in recipient or donor characteristics by LD age group. LD age ≥50 y was associated with an adjusted hazard ratio of 1.49 (P = 0.012) for recipient survival and 1.61 (P < 0.001) for graft survival (vs LDs aged 18-29 y). The negative impact of increasing donor age on graft survival was more profound after LDLT than deceased donor liver transplantation (interaction P = 0.019). There was a possible increased rate of early donor biliary complications for donors >55 y (7.1% versus 3.1% for age <40 y; P = 0.156). Conclusions. Increasing LD age is associated with decreased recipient and graft survival, although older donors still largely yield acceptable outcomes. Donor outcomes were not clearly impacted by increasing age, though this warrants further study. (Transplantation 2023;107: 162-171).

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“…There were no significant group differences. In addition, in 11 studies of 742 patients, 87% of respondents were satisfied with the treatment effect and 95% believed that treatment and time intervals are long [ 18 ].…”

Section: Perioperative Conditionmentioning

confidence: 99%

The Application and Efficacy Evaluation of Autologous Fat Transplantation in Antiaging of the Face: Systematic Review and Meta-Analysis

Zhang²,

Zhang

2022

Journal of Healthcare Engineering

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Objective. To evaluate the therapy of autologous fat fine-grain transplantation in the application of antiaging facial by metaelaboration method. Methods. In Chinese and English databases, such as Wanfang, Weipu, CNKI, PubMed, Cochrane Library, and EMBASE, the literature on the use of autologous fat fines graft in antiaging facial was collected, covering randomized comparative trials, nonrandomized comparative studies, comparative case studies, cohort studies, case reports, and so forth. Meta-analyses were also conducted on complication rates, beauty seeker satisfaction, and one-shot success rates. Results. This study included 23 studies that held metaelaborations, including a total of 2852 beauty seekers. According to metaelaboration, the complication rate was 0.02 (95% CI: 0.01, 0.04), the satisfaction rate of beauty seekers was 0.95 (95% CI: 0.91, 0.97), and the success rate of one injection is 0.79 (95% CI: 0.73, 0.84). Conclusion. Autologous fat fine-grain transplantation is obvious and stable in the use of antiaging facial, and it is necessary to popularize the use in clinical practice.

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Magnetic resonance imaging‐derived proton density fat fraction (MRI‐PDFF) is a viable alternative to liver biopsy for steatosis quantification in living liver donor transplantation

Cited by 12 publications

References 33 publications

Characterization of hepatic steatosis using controlled attenuation parameter and MRI‐derived proton density fat fraction in living donor liver transplantation

Characterization of hepatic steatosis using controlled attenuation parameter and MRI‐derived proton density fat fraction in living donor liver transplantation

Impact of Older Donor Age on Recipient and Graft Survival After LDLT: The US Experience

The Application and Efficacy Evaluation of Autologous Fat Transplantation in Antiaging of the Face: Systematic Review and Meta-Analysis

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