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ABSTRACT: Aim
Approximately 30 years have passed since the first experience of living donor liver transplantation. The time to evaluate the long-term safety of living donors has been fulfilled. Meanwhile, nonalcoholic fatty liver disease is increasingly common and a critical problem. The aim of this study was to evaluate the safety of living donor, focusing on fatty liver postdonation hepatectomy.Methods
Living donors (n = 212, 1997-2019) were evaluated by computed tomography (CT) at >1-year postdonation. A liver to spleen (L/S) ratio of <1.1 was defined as fatty liver.Results
Among 212 living liver donors, 30 (14.2%) detected fatty liver at 5.3 ± 4.2 years postdonation. The cumulative incidence rates of fatty liver were 3.1%, 12.1%, 22.1%, and 27.7% at 2, 5, 10, and 15 years postdonation, respectively. Of 30 subjects who developed fatty liver, 18 (60%) displayed a severe steatosis (L/S ratio <0.9). Five (16.7%) had a prior history of excessive alcohol abuse. More than 30% developed metabolic syndrome including obesity, hyperlipidemia, and diabetes. Although six (20%) had a Fib-4 index of >1.3, which included a case with a Fib-4 index of >2.67, no significant increased Fib-4 index was observed in the subjects with fatty liver as compared to those without fatty liver (p = 0.66). The independent predictive risk factors for developing fatty liver were male sex, pediatric recipient, and higher body mass index (>25) at donation.Conclusion
Living donors with risk factors for developing fatty liver should be carefully followed-up for the prevention and management of metabolic syndrome.
SUBMITTER: Goto R
PROVIDER: S-EPMC10319612 | biostudies-literature | 2023 Jul
REPOSITORIES: biostudies-literature
Goto Ryoichi R Kawamura Norio N Watanabe Masaaki M Ganchiku Yoshikazu Y Nagatsu Akihisa A Okada Kazufumi K Ito Yoichi M YM Kamiyama Toshiya T Shimamura Tsuyoshi T Taketomi Akinobu A
Annals of gastroenterological surgery 20230202 4
<h4>Aim</h4>Approximately 30 years have passed since the first experience of living donor liver transplantation. The time to evaluate the long-term safety of living donors has been fulfilled. Meanwhile, nonalcoholic fatty liver disease is increasingly common and a critical problem. The aim of this study was to evaluate the safety of living donor, focusing on fatty liver postdonation hepatectomy.<h4>Methods</h4>Living donors (<i>n</i> = 212, 1997-2019) were evaluated by computed tomography (CT) a ...[more]