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Safety of right liver donation after improving steatosis through weight loss in living donors: a retrospective study

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Abstract

Background

Living donor liver transplantation using hepatic steatosis-improved grafts mitigates donor shortage. Herein, we aimed to evaluate the safety and feasibility of right-lobe adult-to-adult living donor liver transplantation using grafts improved through donor weight loss.

Methods

In this retrospective study conducted in a single institution in the Republic of Korea, we reviewed the medical records of living liver donors who lost ≥ 10% of their body weight to improve steatosis before right lobe donation between January 2015 and December 2020. Overall, 1040 right-lobe donors were included, with 150 and 890 donors in the weight loss and control (non-steatosis) groups, respectively.

Results

We performed 1:1 individual matching using the greedy matching method, by which 124 patients were included in each group. The median period from the date of the first visit to donation was 113 (interquartile range: 78–184) days in the weight loss group. As body weight changed from 82.8 ± 13.7 kg to 70.8 ± 11.8 kg (p < 0.0001), body mass index also improved from 27.8 ± 3.9 kg/m2 to 23.8 ± 3.1 kg/m2 (p < 0.0001). No significant between-group differences existed in the postoperative laboratory data for living donors and recipients. The incidence of postoperative complications in donors was comparable between the groups (control group, 9.7%; weight loss group, 13.7%; p = 0.3185). The graft and recipient survival rates were comparable between the groups (p = 1.000).

Conclusion

Weight loss through diet and exercise significantly could improve hepatic steatosis in living donor candidates for liver transplantation, with the surgical outcomes in recipients and donors being equivalent to those in recipients and non-steatotic donors.

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Data availability

All data included in this study are available upon request by contact with the corresponding author.

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Authors and Affiliations

  1. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, Republic of Korea

    Young-In Yoon, Sung-Gyu Lee, Shin Hwang, Ki-Hun Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung & Gil-Chun Park

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  1. Young-In Yoon
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  2. Sung-Gyu Lee
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Contributions

Conception and design: Y-IY, S-GL. Administrative support: K-HK, C-SA, D-BM. Provision of study materials or patients: SH. Collection and assembly of data: T-YH, G-WS, D-HJ, G-CP. Data analysis and interpretation: Y-IY. Manuscript writing: All authors. Final approval of manuscript: S-GL.

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Correspondence to Sung-Gyu Lee.

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Yoon, YI., Lee, SG., Hwang, S. et al. Safety of right liver donation after improving steatosis through weight loss in living donors: a retrospective study. Hepatol Int (2024). https://doi.org/10.1007/s12072-024-10641-1

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