Preoperative Evaluation of Liver Parenchyma of Potential Donors in Living Donor Liver Transplantation

Novruzov, Namig; Bayramov, Nuru; Mammadov, Emin

doi:10.1016/j.transproceed.2019.04.070

Cited by 8 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the confirmation of histological improvement after the treatment is mandatory, inevitable complications should be considered when liver biopsy is performed, especially in the case of steatotic liver. Indeed, the most recent study by Novruzov et al demonstrated that CT scans can provide detailed evaluation of liver parenchyma to avoid unnecessary liver biopsy [21]. Thus, we selected imaging (CT L and CT L/S ) for screening rather than liver biopsy, to avoid the risk of biopsyrelated complications.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver

et al. 2020

View full text Add to dashboard Cite

The aim of this study was to determine the efficacy of treating donors' fatty liver (FL) and to assess early graft function in recipients who received treated FL grafts in living-donor liver transplantation (LDLT). Material/Methods:Data were collected for adult-to-adult LDLTs. Donors diagnosed with FL (FL group) received diet-exercise and pharmacological treatment. The perioperative findings and early transplanted graft function were compared with those of donors without FL (non-FL group) during the same period. Results:Of 30 donors, 8 were determined to have FL. The median duration of treatment for FL was 58 days. The liver-tospleen attenuation ratios on CT scan in the FL group were significantly improved after treatment: 0.95 (0.62-1.06) to 1.2 (1.12-1.46) (P=0.003). Liver biopsy prior to donor surgery showed £10% fatty infiltration. Postoperative laboratory findings of the donors in the FL group were comparable to those in the non-FL group: maximum alanine transaminase (189.6±94.7 IU/L vs. 196.8±57.4) and maximum total bilirubin (2.2±1.1 mg/dL vs. 1.7±0.5 mg/dL). No major complications were observed after donor hepatectomy in either group. There were no significant differences between the 2 groups in early graft function, as evaluated by laboratory data, ascites volume, and bile production 2 weeks postoperatively. Graft and patient survival were 100% in both groups at 3 months. Conclusions:Preoperative intentional treatment for FL was effective. Early graft function and donor postoperative course were comparable in the 2 groups. These results suggest that well-treated steatotic grafts can be used without jeopardizing donor safety.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver

et al. 2020

View full text Add to dashboard Cite

show abstract

“…However, hepatic steatosis is reported to be a risk factor for postoperative graft dysfunction in transplantation. [2,15] In cases of transplantation, macrovesicular steatosis affecting more than 30% of the hepatocytes which is thought to be associated with the metabolic syndrome and alcohol abuse,[16] was reported to be associated with an increased risk of primary graft dysfunction and graft loss due to IR injury. [2-3, 5, 15, 17-18] Macrovesicular steatosis, which is characterized by intracellular lipid accumulation and increases in the hepatocyte volume, leads to obstruction of the adjacent sinusoid spaces, and increasing vascular resistance in the hepatic microcirculation leads to mitochondrial dysfunction during reperfusion.…”

Section: Discussionmentioning

confidence: 99%

Fatty Liver Does Not Increase the Risk of Postoperative Liver Damage Following Hepatectomy

et al. 2022

View full text Add to dashboard Cite

BackgroundThe number of patients with fatty liver due to alcohol consumption, the metabolic syndrome, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis is increasing. Because there is no consensus on the risk of hepatectomy in patients with fatty liver, this study examined the clinical outcomes of hepatectomy in fatty liver patients by evaluation their transaminase levels. MethodsPatients (n = 164) who underwent hepatectomy for primary liver tumors from January 2014 to March 2019 were included in the study. They were divided into the steatohepatitis (n = 19), steatosis (n = 20), and viral hepatitis (n = 30) groups. Serum values of aspartate aminotransferase (AST), alanine transaminase (ALT), total bilirubin (TB), white blood cells, and platelets level and the prothrombin time (PT) were compared before and immediately after surgery, and on postoperative days 1-5, 7, and 10. ResultsOverall, the AST and ALT elevation rates were higher in the control group than in the steatosis and steatohepatitis groups during postoperative days 2-7. There was no difference in postoperative hepatic dysfunction between the steatosis and steatohepatitis groups. Univariate analysis revealed signi cant differences in liver stiffness, operative time, mobilization, and the Pringle time.Multivariate analysis indicated low liver stiffness and a longer Pringle time as independent risk factors. Postoperative changes in the TB and albumin levels and the PT did not differ between the groups. There was no difference in the postoperative complications and hospital stay length between the groups. ConclusionsFatty liver does not increase the risk of postoperative liver damage following hepatectomy.

show abstract

“…It was the aim of our study to examine the effect of liver grafts of different steatotic grades on outcomes after OLT. Evaluation of whether there was steatosis by the surgeons, according to appearance and hardness, during procurement is subjective and susceptible to errors [20]. Additionally, liver grafts from other centres have insufficient information, such as the history and laboratory results of the donors.…”

Section: Discussionmentioning

confidence: 99%

Application of ischaemia‐free liver transplantation improves prognosis of patients with steatotic donor livers – a retrospective study

Chen

Lin

et al. 2021

Transpl Int

View full text Add to dashboard Cite

The use of steatotic livers in liver transplantation (LT) is controversial. Ischaemia-free liver transplantation (IFLT) has obvious advantages for the recovery of allograft function. The aim of this study was to examine the effect of liver grafts with steatosis on outcome and the effect of IFLT with steatotic livers. 360 patients with LT were enrolled in this study. Perioperative characteristics and differences in outcome among different grades of steatotic groups, and between the IFLT and conventional LT (CLT) groups were analysed. Occurrence of early allograft dysfunction (EAD; 50%) and primary nonfunction (PNF; 20%) was significantly higher in the severe steatosis group (P < 0.001 and <0.001, respectively). Survival rate is significantly low in severe steatosis group (3-year: 60%, P = 0.0039). The IFLT group had a significantly lower occurrence of EAD than the CLT group (0% vs. 60%, P = 0.01). The level of postoperative peak AST, GGT and creatine were significantly lower in IFLT group (P = 0.009, 0.032 and 0.024, respectively). In multivariable analysis, IFLT and EAD were independent factors affecting postoperative survival. Severe steatotic livers lead to severe complications and poor outcomes in LT. IFLT has obvious advantages for reducing the rate of EAD in LT with steatotic livers.

show abstract

Preoperative Evaluation of Liver Parenchyma of Potential Donors in Living Donor Liver Transplantation

Cited by 8 publications

References 4 publications

Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver

Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver

Fatty Liver Does Not Increase the Risk of Postoperative Liver Damage Following Hepatectomy

Application of ischaemia‐free liver transplantation improves prognosis of patients with steatotic donor livers – a retrospective study

Contact Info

Product

Resources

About