LT, Other : O-064 ; High prevalence of steatosis among liver donors who had no evidence of fatty liver on ultrasonography justifies pre-operative liver biopsy = LT, Other : O-064 ; High prevalence of steatosis among liver donors who had no evidence of fatty liver on ultrasonography justifies pre-operative liver biopsy

다국어 초록 (Multilingual Abstract)

Background: The degree of steatosis of donated liver is one of decisive factors that determine graft function in recipient and recovery of remnant liver in living donor. Hence, the assessment of hepatic steatosis is a critical element to judge donor compatibility. We evaluated the prevalence and predictors of steatosis among liver donors who had no evidence of fatty liver on screening ultrasonography (US-negative). Methods: Degree of hepatic steatosis was reviewed for 492 US-negative liver donors (age: 30.1 ± 9.9, male: 301 (61.2%)). Clinical and laboratory variables were analyzed to identify predictors for steatosis. Results: The prevalence of severe (≥ 60%), moderate (30 ∼ 59%), mild (5 ∼ 29%) and no steatosis (<5%) were 0.6% (3/492), 10.8% (53/492), 39.6% (195/492) and 49.0% (241/492), respectively. In multivariate analysis, BMI [kg/㎡, OR (95% CI): 1.15, p = 0.021] and serum triglyceride level [mg/dl, OR (95% CI): 1.01, p = 0.004] were independent factors associated with steatosis ≥ 30%. The optimal cutoff for steatosis ≥ 30% by receiver operator curve analysis was 23 kg/㎡ for BMI and 88 mg/dl for triglyceride. Steatosis ≥ 30% was significantly more prevalent for liver-donors with high BMI (15.2% vs. 9.0% for BMI ≥ 23 vs. < 23 kg/m2, p = 0.034) and with high serum triglyceride level (15.5% vs. 8.7% for triglyceride ≥ 88 vs. < 88 mg/dl, p = 0.021). Based on these two parameters, the prevalence of steatosis ≥ 30% was 6.6%, 13.0% and 28.6% for none, one and both risk factors, respectively. Conclusions: About a half of US-negative liver donors have steatosis ≥ mild degree and one-tenth of them has ≥ moderate degree. USG assessment is not sufficient to exclude donors with significant steatosis especially for those with high BMI and triglyceride level, and thus, pre-operative liver biopsy should be positively considered for them.