Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver Transplantation.

IF 1.1 4区 医学 Q3 SURGERY
Ahmet Atasever, Sinan Efe Yazıcı, Tolga Şahin, Yıldıray Yuzer
{"title":"Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver Transplantation.","authors":"Ahmet Atasever, Sinan Efe Yazıcı, Tolga Şahin, Yıldıray Yuzer","doi":"10.12659/AOT.947772","DOIUrl":null,"url":null,"abstract":"<p><p>BACKGROUND Living donor liver transplantation (LDLT) faces increasing challenges due to the rising prevalence of hepatic steatosis among potential donors. Moderate steatosis (30-60%) is particularly problematic, often leading to donor exclusion and reducing the available donor pool. Preoperative interventions aiming to reduce hepatic fat content have emerged as a potential strategy, but data regarding their safety and efficacy remain limited. MATERIAL AND METHODS This retrospective, single-center study evaluated 34 living liver donors between June 2023 and August 2024. Fourteen donors received preoperative treatment for moderate hepatic steatosis, while 20 donors with mild or no steatosis served as controls. Pre- and post-treatment assessments included body mass index (BMI), liver fat assessment via computed tomography (CT), liver function tests, and perioperative outcomes. RESULTS Preoperative treatment significantly reduced hepatic fat content, with all treated donors achieving steatosis levels below 30% (P<0.001). BMI and GGT levels also decreased significantly after treatment (P=0.01 and P=0.04, respectively). Postoperative liver function, intensive care unit stay, and hospital discharge times were comparable between the treated and control groups (P>0.05). No donor experienced serious complications during the early postoperative period or the first year of follow-up. All donors maintained satisfactory graft and remnant liver function, and no treatment-related adverse events were observed. CONCLUSIONS Preoperative management of moderate hepatic steatosis in living liver donors is effective in reducing liver fat to acceptable levels without compromising donor safety. This approach offers a promising strategy to expand the LDLT donor pool. Further large-scale, multicenter studies with extended follow-up are necessary to validate these findings.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":"30 ","pages":"e947772"},"PeriodicalIF":1.1000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125959/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12659/AOT.947772","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

BACKGROUND Living donor liver transplantation (LDLT) faces increasing challenges due to the rising prevalence of hepatic steatosis among potential donors. Moderate steatosis (30-60%) is particularly problematic, often leading to donor exclusion and reducing the available donor pool. Preoperative interventions aiming to reduce hepatic fat content have emerged as a potential strategy, but data regarding their safety and efficacy remain limited. MATERIAL AND METHODS This retrospective, single-center study evaluated 34 living liver donors between June 2023 and August 2024. Fourteen donors received preoperative treatment for moderate hepatic steatosis, while 20 donors with mild or no steatosis served as controls. Pre- and post-treatment assessments included body mass index (BMI), liver fat assessment via computed tomography (CT), liver function tests, and perioperative outcomes. RESULTS Preoperative treatment significantly reduced hepatic fat content, with all treated donors achieving steatosis levels below 30% (P<0.001). BMI and GGT levels also decreased significantly after treatment (P=0.01 and P=0.04, respectively). Postoperative liver function, intensive care unit stay, and hospital discharge times were comparable between the treated and control groups (P>0.05). No donor experienced serious complications during the early postoperative period or the first year of follow-up. All donors maintained satisfactory graft and remnant liver function, and no treatment-related adverse events were observed. CONCLUSIONS Preoperative management of moderate hepatic steatosis in living liver donors is effective in reducing liver fat to acceptable levels without compromising donor safety. This approach offers a promising strategy to expand the LDLT donor pool. Further large-scale, multicenter studies with extended follow-up are necessary to validate these findings.

活体肝移植术前治疗对供肝脂肪变性的影响。
背景活体供肝移植(LDLT)面临着越来越大的挑战,因为潜在供体中肝脂肪变性的患病率不断上升。中度脂肪变性(30-60%)尤其成问题,常常导致供体排斥,减少可用供体池。旨在降低肝脏脂肪含量的术前干预措施已成为一种潜在的策略,但有关其安全性和有效性的数据仍然有限。材料和方法本回顾性单中心研究评估了2023年6月至2024年8月期间34名活体肝供者。14例肝脂肪变性患者接受术前治疗,20例轻度或无脂肪变性患者作为对照组。治疗前和治疗后的评估包括体重指数(BMI)、通过计算机断层扫描(CT)评估肝脏脂肪、肝功能检查和围手术期结果。结果术前治疗显著降低肝脏脂肪含量,所有接受治疗的供体脂肪变性水平均低于30% (P0.05)。在术后早期或随访的第一年,供体均未出现严重并发症。所有供者均保持满意的移植和残肝功能,未观察到与治疗相关的不良事件。结论:对活体肝供体进行中度肝脂肪变性的术前管理可以有效地将肝脂肪降低到可接受的水平,同时不影响供体的安全性。这种方法为扩大LDLT供体库提供了一种有希望的策略。需要进一步的大规模、多中心的长期随访研究来验证这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
0.00%
发文量
79
审稿时长
>12 weeks
期刊介绍: Annals of Transplantation is one of the fast-developing journals open to all scientists and fields of transplant medicine and related research. The journal is published quarterly and provides extensive coverage of the most important advances in transplantation. Using an electronic on-line submission and peer review tracking system, Annals of Transplantation is committed to rapid review and publication. The average time to first decision is around 3-4 weeks. Time to publication of accepted manuscripts continues to be shortened, with the Editorial team committed to a goal of 3 months from acceptance to publication. Expert reseachers and clinicians from around the world contribute original Articles, Review Papers, Case Reports and Special Reports in every pertinent specialty, providing a lot of arguments for discussion of exciting developments and controversies in the field.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信