2016 - IPTA Fellows Meeting


Mini-Oral Abstract Presentations

14.38 - Steatosis in Living Related Donor: Is a predisposing factor for NASH in the recipients?

Presenter: Victoria, Fernandez de Cuevas , Buenos Aires, Argentina
Authors:


Steatosis in Living Related Donor: Is a predisposing factor for NASH in the recipients?

Victoria Fernandez de Cuevas 1, Marina Orsi1, Daniel D' Agostina1.

1 1 Division of Pediatric Gastroenterology and Hepatology, Liver and Intestinal Transplant Center., Hospita Italiano, Buenos Aires, Argentina

 

Introduction:
Living related donors (LRD) increase the availability of organs for liver transplantation (LTx), decreasing waiting list mortality.

The presence of fatty liver in the potential donor is frequently found during evaluations, which complicates the donation.

Aim:

  •  Analyze the presence of fatty liver (FL) in the population evaluated for Living Related Donor(LRD).
  •  Evaluate if the presence of a  fatty liver in the donor is a predisposing factor to the development of steatosis in  recipients.

Material and Methods:
Descriptive and retrospective study. 173 patients were evaluated as potential LRD at  the Liver Trasplant Center of the  Hospital Italiano between 2005 – 2015.
129 patients (pts) were included. They were divided into 2 groups: DNFLD: Donors without FL on the biopsy and DFLD: donors with FL on the biopsy.
43 transplants were done with LRD. The recipients were divided  in the same way: Recipients: donor without history of FL and Recipients: donor with history FL.

Results:

Donors Group: 129 pts  included,43 were selected to be LRD.

  • DNFLD: 26 out of 78 pts were selected as LRD(33%) ,X age: 27.7y(r 18 - 44 y),18F/8 M , X Cholesterol: 176.81mg/dl  X AST: 21 U/L, X ALT:26 U/L.
  • DFLD: 17 out of 51 pts were selected as LRD (33%),X age: 33.2 y(r 24 - 42 y), 9F/8M , X cholesterol: 189.5 mg/dl, X AST: 25 U/L, X ALT:30 U/L

Recipients Groups: 43 pts were included.

  • R (DNFLD) : 26 recipients,  X age: 19.3m (r 8 – 72 m),17 F/9M. 8 pts (30.7%) presented steatosis in the post transplant follow-up (3/8 were associated to acute cellular rejection).
  • R(DFLD):17 recipients, X age: 19.5 m( r 8 – 35 m),10F/7M,  4 pts (23.5%) presented FL in the post transplant follow-up ( 2/4 were associated with acute cellular rejection)

R(DFLD):17 recipients, X age: 19.5 m( r 8 – 35 m),10F/7M,  4 pts (23.5%) presented FL in the post transplant follow-up ( 2/4 were associated with acute cellular rejection)

Conclusions: The presence of fatty liver in the post-transplant follow-up may be due to multifactorial etiology and pathogenesis. The observed pattern was predominantly macro-microvacuolar. In our experience, an adequate selected donor, with history of fatty liver if properly treated is not a predisposing factor for the development of NASH in the recipients. More studies are needed to confirm this  result.

 

References:

[1] • World J Gastroenterol. 2014 Nov 14;20(42):15532-8. doi: 10.3748/wjg.v20.i42.15532. •Liver transplantation and non-alcoholic fatty liver disease.
[2] Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis and orthotopic liver transplantation. Burke A, Lucey MR. Am J Transplant. 2004 May;4(5):686-93. .


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