Transient Elastography to Evaluate Steatosis in Candidate Living Donors for Liver Transplantation
1Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 2Columbia University Mailman School of Public Health, New York, NY, 3Department of Pathology and Cell Biology, Columbia University, New York, NY, 4Department of Surgery, Columbia University, New York, NY, 5Department of Surgery, Weill Cornell Medicine, New York, NY, 6Department of Medicine, Columbia University, New York, NY, 7Department of Medicine, Division of Digestive and Liver Diseases, Columbia University, New York, NY
Meeting: 2020 American Transplant Congress
Abstract number: D-126
Keywords: Liver, Liver transplantation, Living donor, Screening
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 donor liver transplantation (LDLT) increases the donor pool and affords a life-saving cure to recipients who do not have MELD-based access to allografts. Hepatic steatosis in the donor organ is associated with increased post-transplant morbidity in the donor and impaired graft function in the recipient. Recent advances in MRI have made possible an accurate determination of hepatic steatosis, and while ultrasound transient elastography (TE) can predict steatosis and graft retrievability in deceased donors using controlled attenuation parameter (CAP) and liver stiffness (LS) indices, it has not been applied to the evaluation of steatosis in potential living donors. The ability of point-of-care TE to reliably exclude significant steatosis in living donors for liver transplantation could obviate the need for liver biopsies to detect steatosis, expedite the donor approval process, and reduce recipient wait time.
*Methods: IRB approval was obtained under the LDLT at the Center for Liver Disease and Transplantation (IRB AAAM5707). 79 living donor candidates who voluntarily presented for evaluation between 2016-2019 underwent standard donor workup and TE by a trained hepatologist. Clinical, demographic, imaging, and biopsy data were collected as necessitated by the living donor evaluation. 71 patients were included in the final analysis. Patients were excluded due to lack of imaging or invalid TE measurements. CAP scores were compared to MRI-Fat Fraction (MRI-FF), a surrogate measure for histologic hepatic steatosis, in order to generate a receiver operating characteristic curve. Statistical analysis was conducted using R (version 3.6.0).
*Results: There were no statistically significant differences in baseline demographics between transplanted and non-transplanted donor grafts. Spearman correlation coefficient for MRI-FF and CAP was 0.424 (p = 0.0002). For detecting MRI-FF <5%, the area under the receiver operating characteristic curve (AUROC) was 0.864. A CAP score of 271.5 dB/m was determined to have 89.8% sensitivity and 75% specificity for detecting <5% steatosis.
*Conclusions: TE can adequately screen for hepatic steatosis in candidate living donors for liver transplant.
To cite this abstract in AMA style:
Palte E, Duong J, Remotti H, Burt J, Griesemer A, Samstein B, Marratta D, Fox AN. Transient Elastography to Evaluate Steatosis in Candidate Living Donors for Liver Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/transient-elastography-to-evaluate-steatosis-in-candidate-living-donors-for-liver-transplantation/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress