Prediction of nonalcoholic fatty liver in prospective liver donors

Choudhary, Narendra S.; Saraf, Neeraj; Saigal, Sanjiv; Duseja, Ajay; Gautam, Dheeraj; Lipi, Lipika; Rastogi, Amit; Goja, Sanjay; Bhangui, Prashant; Ramchandra, Sumana K.; Babu, Yalakanti R.; Soin, Arvinder S.

doi:10.1111/ctr.12890

Cited by 12 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The donors had a liver biopsy during evaluation in presence of the following: a low graftto-recipient weight ratio (0.6-0.8), remnant volume <35%, liver attenuation index <5 (difference of liver and splenic attenuation on noncontrast CT), and in presence of 2 or more metabolic risk factors. 9 Donors with more than 20% steatosis, or nonalcoholic steatohepatitis or fibrosis on biopsy were rejected.…”

Section: Donor Selection Criteriamentioning

confidence: 99%

Good Long-Term Outcomes in Patients With Primary Sclerosing Cholangitis Undergoing Living Donor Liver Transplantation

Choudhary

Saigal

Thummala

et al. 2020

Journal of Clinical and Experimental Hepatology

Self Cite

View full text Add to dashboard Cite

Background: Primary sclerosing cholangitis (PSC) is a progressive cholestatic disorder with liver transplantation (LT) being the only definitive treatment in end-stage disease. Recurrence of PSC after LT is a significant concern which can lead to graft loss. The aim of this study is to find out the disease recurrence and long-term outcome after living donor liver transplantation (LDLT) in PSC. Methods: We conducted a retrospective review of all patients undergoing LDLT for PSC at our centre. Of 2268 adult LTs from August 2004 to July 2018, 32 (1.4%) patients underwent LDLT for PSC including 6 with PSC and autoimmune hepatitis overlap. The data were reviewed to look for PSC recurrence, complications, and overall survival. All patients received tacrolimus-based immunosuppression. Data are shown as number, percentage, median, and interquartile range (IQR). Result: The mean age of 32 LDLT recipients was 44 ± 12 years (males 22, females 10). At the time of transplantation, the mean child's score was 9 ± 1.6 and model for end-stage liver disease score was 18.9 ± 6.4. Ulcerative colitis was seen in 7 patients and none had cholangiocarcinoma. Majority of patients (n = 29) received right lobe graft and all but 3 underwent hepaticojejunostomy for biliary reconstruction. PSC recurrence was seen in 6 (20%) patients during a median follow-up of 59 (29-101) months, after exclusion of 2 patients with early mortality. A total of five patients died during follow-up, and one of these deaths was due to PSC recurrence. There were 2 perioperative deaths due to sepsis and 3 deaths on follow-up (sepsis in 2 and PSC recurrence in 1). Conclusion: LDLT can be performed in PSC with good overall long-term outcomes.

show abstract

Section: Donor Selection Criteriamentioning

confidence: 99%

Good Long-Term Outcomes in Patients With Primary Sclerosing Cholangitis Undergoing Living Donor Liver Transplantation

Choudhary

Saigal

Thummala

et al. 2020

Journal of Clinical and Experimental Hepatology

Self Cite

View full text Add to dashboard Cite

show abstract

“…This is similar to a previous report from our center that a liver biopsy should be performed in presence of 2 or more metabolic risk factors in prospective liver donors to diagnose NAFLD. 9 Several studies have defined lean as BMI < 25 kg/m 2 (including studies from India) and have shown 3.7-27.4% prevalence of NAFLD in lean individuals from different regions of the world. 11 Thus, these studies include overweight patients (BMI >23 to <25 kg/m 2 ) and should not be considered true lean population.…”

Section: Discussionmentioning

confidence: 99%

“…The earlier studies from India have shown that NAFLD is common. [5][6][7][8][9] As we work at a liver transplantation center and living donor liver transplantation is more common than deceased donor liver transplantation, donor liver biopsies during presurgery work up provide us opportunity to study NAFLD in apparently healthy individuals with near normal liver enzymes. We describe a profile of NAFL in lean liver donors diagnosed during work up.…”

mentioning

confidence: 99%

Nonalcoholic Fatty Liver in Lean Individuals: Clinicobiochemical Correlates of Histopathology in 157 Liver Biopsies from Healthy Liver Donors

Choudhary

Saraf

Saigal

et al. 2021

Journal of Clinical and Experimental Hepatology

Self Cite

View full text Add to dashboard Cite

Background: Generally diagnosis of non-alcoholic fatty disease is made on imaging, however, mild steatosis is difficult to diagnose on imaging. Liver biopsy is the procedure of choice but is not carried out as it is an invasive procedure. We describe our experience of 157 liver biopsies in living liver donors with normal body mass index (BMI) <23 kg/M 2 (lean). Materials and methods: The study was conducted at a tertiary care center in north India. Data of lean living donors who underwent a liver biopsy before donation were analyzed. Data are presented as percentage, mean, or median (25-75 interquartile range). Results: Of 718 donors who had a liver biopsy before donation, 157 (21.8%) donors were lean (BMI < 23 kg/M 2 ). Seventy-eight percent of lean donors had no or only one metabolic risk factor. Fifty-three (33.7%) of lean donors had nonalcoholic fatty liver (NAFL) in liver biopsy. When donors with NAFL were compared to donors with normal histology, donors with NAFL had significantly higher aspartate transaminase (26.6 ± 7.5 versus 23.7 ± 5.4, p = 0.007), alanine transaminase (33.4 ± 11.7 versus 27.8 ± 10.7, p = 0.003), and gamma glutamyl transpeptidase [25 (16-40.5) versus 18 (14-23), p = 0.003]. Only triglycerides (TGs) were statistically different among metabolic factors in lean NAFL and normal histology groups, 97 (70-161) versus 86 (62.5-114.7), p = 0.043. A total of 30% donors in the lean NAFL group had TGs >150 mg/dl as compared with 12.5% in the normal histology group, p = 0.009. Other metabolic risk factors were not statistically different. Conclusion: One third of lean donors had NAFL. Among all metabolic risk factors, only higher TGs levels showed a significant association with NAFL. ( J CLIN EXP HEPATOL xxxx;xxx:xxx) This study was conducted at a tertiary care center in north India. The study included all liver donors who underwent a liver biopsy before actual donation from July 2010 to January 2018. Data were retrospectively analyzed from a prospective collected database. Institute's ethical

show abstract

“…A higher BMI and diabetes at transplant, steatohepatitis as underlying disease, and new‐onset diabetes were significantly associated with de novo steatosis in our patients after 5 years (Table 3). Various studies have identified an increased BMI as the main risk factor for steatosis of the graft 39‐42 . The group of patients with de novo steatosis also included 15 patients with primary viral hepatitis, which might influence histopathological findings.…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have identified an increased BMI as the main risk factor for steatosis of the graft. [39][40][41][42] The group of patients with de novo steatosis also included 15 patients with primary viral hepatitis, which might influence histopathological findings. However, there was no significant demographic difference between the groups, whereas we did not correct this issue during analysis.…”

Section: Discussionmentioning

confidence: 99%

Association between obesity after liver transplantation and steatosis, inflammation, and fibrosis of the graft

Dobrindt

Allex

Saipbaev

et al. 2020

Clinical Transplantation

View full text Add to dashboard Cite

During the last decades, advanced surgical techniques and immunosuppressive therapy have led to excellent survival after liver transplantation. The survival rates reach up to 83% after 1 year, 61% after 10 years, and 41% after 20 years. 1 However, there is an increase in medical complications unrelated to the graft, such as de novo malignancies, recurrence of the underlying disease, metabolic complications, and cardiovascular diseases. 2-7 Cardiovascular factors cause 19%-42% of all deaths after liver transplantation. The individual cardiovascular risk profile is thought to be affected by metabolic syndrome, which is at least partially associated with immunosuppressive therapy. 2,4,7,8 Metabolic syndrome is defined by obesity, dyslipidemia, arterial hypertension, and hyperglycemia, and is one of the most frequent post-transplant complications. Its prevalence after transplantation ranges from 44% to 58% according to

show abstract

Prediction of nonalcoholic fatty liver in prospective liver donors

Abstract: The presence of ≥2 metabolic risk factors improves sensitivity of CT-LAI for prediction of donor steatosis.

Cited by 12 publications

References 20 publications

Good Long-Term Outcomes in Patients With Primary Sclerosing Cholangitis Undergoing Living Donor Liver Transplantation

Good Long-Term Outcomes in Patients With Primary Sclerosing Cholangitis Undergoing Living Donor Liver Transplantation

Nonalcoholic Fatty Liver in Lean Individuals: Clinicobiochemical Correlates of Histopathology in 157 Liver Biopsies from Healthy Liver Donors

Association between obesity after liver transplantation and steatosis, inflammation, and fibrosis of the graft

Contact Info

Product

Resources

About