Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) is a viable alternative to liver biopsy for steatosis quantification in living liver donor transplantation.
Qiaochu QiAllison K WeinstockKalina ChupetlovskaAmir A BorhaniDana R JorgensenAlessandro FurlanJaideep BehariMichele MolinariSwaytha GaneshAbhinav HumarAndrés Duarte-RojoPublished in: Clinical transplantation (2021)
This study aimed to investigate whether magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) can be a viable noninvasive alternative to liver biopsy for the quantification of living liver donor steatosis. Hepatic steatosis for 143 donors was graded by MRI-PDFF. Study endpoints included liver volume regeneration in donors, recipient outcomes including length of hospital stay, deaths, primary non-function (PNF), early allograft dysfunction (EAD), and small for size syndrome (SFSS). Correlation between MRI-PDFF determined donor steatosis and endpoints were analyzed. Donors had lower steatosis grade than non-donors. Donor remnant liver regenerated to an average of 82% of pre-donation volume by 101 ± 24 days with no complications. There was no correlation between percent liver regeneration and steatosis severity. Among recipients, 4 underwent redo-transplantation and 6 died, with no association with degree of steatosis. 52 recipients (36%) fulfilled criteria for EAD (driven by INR), with no difference in hepatic steatosis between groups. MRI-PDFF reliably predicted donor outcomes. Living donors with no or mild steatosis based on MRI-PDFF (ie, <20%) and meeting other criteria for donation can expect favorable post-surgical outcomes, including liver regeneration. Recipients had a low rate of death or retransplantation with no association between mild hepatic steatosis and EAD.
Keyphrases
- magnetic resonance imaging
- contrast enhanced
- insulin resistance
- high fat diet
- kidney transplantation
- stem cells
- diffusion weighted imaging
- high fat diet induced
- computed tomography
- healthcare
- heart failure
- magnetic resonance
- cell therapy
- coronary artery disease
- metabolic syndrome
- left ventricular
- case report
- transcatheter aortic valve replacement
- glycemic control