Affiliation:
1. Department of Gastroenterological Surgery I Hokkaido University Graduate School of Medicine Sapporo Japan
2. Department of Transplant Surgery Hokkaido University Graduate School of Medicine Sapporo Japan
3. Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care Hokkaido University Hospital Sapporo Japan
4. Division of Organ Transplantation Hokkaido University Hospital Sapporo Japan
Abstract
AbstractAimApproximately 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.MethodsLiving 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.ResultsAmong 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.ConclusionLiving donors with risk factors for developing fatty liver should be carefully followed‐up for the prevention and management of metabolic syndrome.
Funder
Japan Society for the Promotion of Science
Cited by
4 articles.
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