Steatosis by PDFF Affects Percent Remnant Liver Regeneration in Living Donors without Impacting on Clinical Outcomes
University of Pittsburgh Medical Center, Pittsburgh, PA
Meeting: 2020 American Transplant Congress
Abstract number: C-154
Keywords: Image analysis, Living-related liver donors, Risk factors, Safety
Session Information
Date: Saturday, May 30, 2020
Session Name: Poster Session C: Liver: Living Donors and Partial Grafts
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Mild steatosis (5-33% of fat) is not expected to affect liver regeneration following partial hepatectomy. Novel methods to assess steatosis, such as proton density fat fraction (PDFF) from MRI provide an accurate and continuous quantification of mild steatosis. We hypothesized that the burden of steatosis could negatively impact liver regeneration even among living donors within the range of mild steatosis by PDFF.
*Methods: Mild steatosis was defined as a PDFF 6.4-17.3%. Preoperative CT-quantified total and remnant liver volumes were compared against follow-up CT volume at 3 months post-donation with % regeneration defined as: 3-month liver volume / baseline liver volume x 100. Apart from demographics, anthropometry and routine chemistry, clinical outcomes were investigated. We used ANCOVA to determine the effect of steatosis on liver regeneration.
*Results: We included 26 living donors with mean age 38±9, male 57%, non-Hispanic white in 96%, and BMI 27±4. Mild steatosis was found in 7 (range of 6.7 to 11.2%). Although there was no difference in % remnant liver between patients with and without steatosis (47±8% and 46±11, p=0.80; respectively), donors with steatosis regenerated to 77±7% and this was lower than what was observed among those without steatosis at 84±8% of baseline (p=0.03). A reduced regenerative capacity was evident for donors with mild steatosis irrespective of the remnant liver volume (Figure). Importantly, there were no episodes of liver failure or deaths identified among donors, and liver chemistry was similar at baseline and 3 months post-donation.
*Conclusions: Although all donors showed 3-month % liver regeneration within the expected range (80±13% from A2ALL), our findings support that mild steatosis, up to a PDFF of 11%, has a negative impact on liver regeneration after living donation. The impact, however, was not thought to be clinically meaningful and this was supported by the lack of abnormalities in liver chemistry and adverse clinical outcomes.
To cite this abstract in AMA style:
Duarte-Rojo A, Qi Q, Chupetlovska K, Jorgensen DR, Borhani AA, Furlan A, Ganesh S, Humar A. Steatosis by PDFF Affects Percent Remnant Liver Regeneration in Living Donors without Impacting on Clinical Outcomes [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/steatosis-by-pdff-affects-percent-remnant-liver-regeneration-in-living-donors-without-impacting-on-clinical-outcomes/. Accessed March 3, 2021.« Back to 2020 American Transplant Congress