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Lose Weight to Donate Program: Preliminary Results of a Program Intended to Optimize Obese Living Donor Liver Candidates

J. Rose1, T. Seay2, A. Pesch3, P. Vargas4, S. Pelletier4, J. Oberholzer4, C. Argo5, N. Goldaracena4

1School of Medicine, University of Virginia Health System, Charlottesville, VA, 2Division of Transplantation, University of Virginia Health System, Charlottesville, VA, 3Radiology Department, University of Virginia Health System, Charlottesville, VA, 4Department of Surgery, Division of Transplantation, University of Virginia Health System, Charlottesville, VA, 5Department of Medicine-Gastroenterology, University of Virginia Health System, Charlottesville, VA

Meeting: 2020 American Transplant Congress

Abstract number: D-125

Keywords: Liver grafts, Living donor, Living-related liver donors, Obesity

Session Information

Session Name: Poster Session D: Liver: Living Donors and Partial Grafts

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Living donation (LD) can alleviate organ shortage, but is limited by obesity compromising organ quality and donor safety. This study intends to assess the feasibility of a diet and exercise program to increase the LD pool.

*Methods: Over a 19-month period, 7 individuals (ages 18-60) enrolled into a diet and exercise program to become LD. Individuals were referred to the program if LD criteria was not met due to significant hepatic steatosis and/or a BMI >30. Program length ranged from 6-10 weeks. Participants would record their weights and activity during that period. Hepatic steatosis was determined by MRI before and after their participation in the weight loss program.

*Results: Pre/post MRI fat fractions were available for 5/7 candidates. Initial imagining demonstrated mild to moderate steatosis (range 7.6-25.8%). Following program completion, a mean 58% reduction in steatosis (43-76%) was achieved. Liver volumes changed by a mean of -15% (-9 to -24%). Mean BMI changes was -6.5% (-3% to -14%). 2/7 participants finally became LD. One candidate had an incidental finding on final imaging that precluded donation despite successful resolution of steatosis. Another candidate had improvement of steatosis but due to concerning anatomy was ruled out from LD. The remaining 3 candidates were no longer needed to donate as their respective recipients got transplanted with a cadaveric graft.

*Conclusions: Our preliminary data indicates that a 6% weight reduction resulted in halving of steatosis on imaging. Lifestyle modification is a feasible means to expand the living liver donor pool in the United States where obesity and fatty liver disease are highly prevalent.

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To cite this abstract in AMA style:

Rose J, Seay T, Pesch A, Vargas P, Pelletier S, Oberholzer J, Argo C, Goldaracena N. Lose Weight to Donate Program: Preliminary Results of a Program Intended to Optimize Obese Living Donor Liver Candidates [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/lose-weight-to-donate-program-preliminary-results-of-a-program-intended-to-optimize-obese-living-donor-liver-candidates/. Accessed May 10, 2025.

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