The effect of donor weight reduction on hepatic steatosis for living donor liver transplantation

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Abstract
Hepatic steatosis is often associated with overweight, so we tried body-weight reduction in potential living donors with fatty liver and/or obesity to alleviate hepatic steatosis. We advised to reducing the body weight by 5% for 9 potential living donors showing hepatic steatosis of 25-95% on initial percutaneous needle biopsy (PCNB). They lost 5.9 ± 2.0% of the initial body weight during 2-6 months and their body mass index changed from 25.3 ± 3.8 to 23.7 ± 3.4. Total amount of hepatic steatosis changed significantly from 48.9 ± 25.6% to 20.0 ± 16.2% before and after weight reduction. The proportional reduction in microvesicular steatosis was more obvious than in macrovesicular fatty changes. Six right lobe and 3 left lobe grafts were procured uneventfully from these 9 donors. All donors recovered uneventfully, and all 9 recipients survived more than 15 months to date. In conclusion, we think that short-term weight reduction of living donors will be helpful to alleviate excessive hepatic steatosis, especially in microvesicular type and can contribute to expand the pool of marginal living donors. (Liver Transpl 2004;10:721-725.)