Lose Weight to Donate: Development of a Program to Optimize Potential Donors With Hepatic Steatosis or Obesity for Living Liver Donation. Issue 6 (25th May 2021)

• Record Type: Journal Article
• Authors: Rose, John T.; Vargas, Paola; Seay, Tara; Pesch, Arthur J.; Williams, Tessa; Sites, Anita; Henry, Zachary; Northup, Patrick G.; Pelletier, Shawn J.; Oberholzer, Jose; Argo, Curtis K.; Goldaracena, Nicolas
• Is Part Of: Transplantation direct. Volume 7:Issue 6(2021)
• Page Start: e702
• Publication Date: 2021-05-25
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation -- Periodicals; 362.19795
• DOI: 10.1097/TXD.0000000000001161
• Languages: English
• ISSNs: 2373-8731

Abstract

Abstract : Background: Living donor liver transplantation offers an attractive option to reduce the waitlist mortality. However, in recent years, the rising prevalence of obesity and nonalcoholic fatty liver disease has posed a serious threat to the donor pool while simultaneously increasing demand for liver transplant. To our knowledge, there have been no major published studies in the United States documenting a diet and exercise intervention to expand the living donor pool. Hereby, we established a pilot program called "Lose Weight to Donate" and present our initial experience. Methods: Our center instituted a remotely monitored diet and exercise pilot program to increase eligibility for living liver donation. Potential donors with any of the following were included: body mass index >30 kg/m 2, hepatic steatosis >5% on screening MRI, or isolated hypertension. Results: Over 19 mo, 7 individuals enrolled in the program of remote monitoring for at least 6–8 wk. Initial and follow-up abdominal MRI was performed in 5 of these individuals to assess steatosis, anatomy, and volume. Initial steatosis was highly variable (fat signal fraction range, 8%–26%). Follow-up MRI fat signal fraction values and hepatic volume all decreased to varying degrees. Ultimately, 2 of 7 individuals donated, whereas a third was approved, but the intended recipient was transplanted in the interim. Conclusions: These results indicate the feasibility of a remotely monitored program to expand donation in light of the rising incidence of hepatic steatosis and obesity. Abstract :