The Utility of Noninvasive Scoring Systems for Prediction of Hepatic Steatosis in Liver Transplantation Donor Candidates

Sahin, Tevfik Tolga; Arikan, Bahadir Turkmen; Serin, Ayfer; Emek, Ertan; Bozkurt, Birkan; Server, Sadık; Dibekoglu, Cengiz; Tokat, Yaman

doi:10.1016/j.transproceed.2019.01.177

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…We noninvasively reviewed indices for NAFLD assessment, including six indices [fatty liver index (FLI), hepatic steatosis index (HSI), SteatoTest, lipid accumulation product (LAP), Index of Nash (ION), NAFLD-Liver Fat Score (LFS)] for liver steatosis and eight indices [AST to platelet ratio index (APRI), Fibrosis-4 (FIB-4), FibroTest, Fibrometer NAFLD, Enhanced Liver Fibrosis (ELF), Hepacore, BARD score, NAFLD fibrosis score (NFS)] for liver fibrosis ( 21 , 22 ). The FLI, HIS, and NFS were selected for this study because these indices can be calculated with only simple laboratory findings, body weight, and circumference using retrospective data.…”

Section: Methodsmentioning

confidence: 99%

Changes in Indices of Steatosis and Fibrosis in Liver Grafts of Living Donors After Weight Reduction

Choi

Hong

et al. 2022

Front. Surg.

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BackgroundA short-term weight reduction program for potential living donors was introduced to reduce the extent of hepatic steatosis prior to liver transplantation. We aimed to investigate changes in non-invasive hepatic steatosis and fibrosis indices among those who completed the program.MethodsAmong 1,950 potential living liver donors between January 2011 and May 2019, 160 living donors joined the weight reduction program. The prospectively collected clinical data of these potential liver donors were analyzed retrospectively. Hepatic steatosis and fibrosis scores were determined using the fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD fibrosis score (NFS) and compared to MR spectroscopy (MRS) fat fraction results before and after weight reduction.ResultsThirty-nine potential living donors who had undergone MRS both before and after weight reduction were included in the analysis. Their body weight decreased from 78.02 ± 10.89 kg to 72.36 ± 10.38 kg over a mean of 71.74 ± 58.11 days. FLI, HSI, and MRS values decreased significantly from 41.52 ± 19.05 to 24.53 ± 15.93, 39.64 ± 3.74 to 35.06 ± 3.82, and 12.20 ± 4.05 to 6.24 ± 3.36, respectively. No significant decreases in NFS were observed. There was a significant correlation between the extent of HSI change and the extent of MRS change (R2 value = 0.69, P < 0.001), although there was no correlation between MRS and FLI.ConclusionThe weight reduction program significantly improved non-invasive indices of hepatic steatosis over a short period. HSI may allow for prediction of simple decreases in hepatic steatosis.

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Section: Methodsmentioning

confidence: 99%

Changes in Indices of Steatosis and Fibrosis in Liver Grafts of Living Donors After Weight Reduction

Choi

Hong

et al. 2022

Front. Surg.

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“…Prior studies have shown that APRI detects NAFLD [51] and ultrasound-detected HS with high sensitivity and specificity [52]. A recent study by Sahin et al further demonstrated the greater utility of APRI in detecting degrees of HS ranging from <10%, 10–20%, 20–30%, and >30% versus multidetector CT (MDCT) [53 ▪ ]. Compared to other noninvasive scoring methods such as the BARD score, NAFLD fibrosis score, and FIB-4 index, APRI's performance is superior, with sensitivity ranging from 49.1 to 59.6% and specificity of 64.1–81.6%.…”

Section: Evaluation Of Hepatic Steatosismentioning

confidence: 99%

Contemporary strategies to assess and manage liver donor steatosis: a review

Tien¹,

Remulla²,

Kwon

et al. 2021

Current Opinion in Organ Transplantation

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Purpose of review Due to a persistent shortage of donor livers, attention has turned toward ways of utilizing marginal grafts, particularly those with steatosis, without incurring inferior outcomes. Here we review the evaluation and utilization of steatotic liver allografts, highlight recently published data, and discuss novel methods of graft rehabilitation. Recent findings Although severe liver allograft (>60%) steatosis has been associated with inferior graft and recipient outcomes, mild (<30%) steatosis has not. There is ongoing debate regarding safe utilization of grafts with moderate (30–60%) steatosis. Presently, no established protocols for evaluating steatosis in donor candidates or utilizing such grafts exist. Liver biopsy is accepted as the gold standard technique, though noninvasive methods have shown promise in accurately predicting steatosis. More recently, machine perfusion has been shown to enhance ex situ liver function and reduce steatosis, emerging as a potential means of optimizing steatotic grafts prior to transplantation. Summary Steatotic liver allografts constitute a large proportion of deceased donor organs. Further work is necessary to define safe upper limits for the acceptable degree of steatosis, develop standardized evaluation protocols, and establish utilization guidelines that prioritize safety. Machine perfusion has shown promise in rehabilitating steatotic grafts and offers the possibility of expanding the deceased donor pool.

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The Utility of Noninvasive Scoring Systems for Prediction of Hepatic Steatosis in Liver Transplantation Donor Candidates

Cited by 2 publications

References 10 publications

Changes in Indices of Steatosis and Fibrosis in Liver Grafts of Living Donors After Weight Reduction

Changes in Indices of Steatosis and Fibrosis in Liver Grafts of Living Donors After Weight Reduction

Contemporary strategies to assess and manage liver donor steatosis: a review

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