Predictors of hepatic steatosis in living liver donors
Fatty liver disease (steatosis) is considered a risk factor in donor liver transplantation (LT). Macrosteatosis (>50%) is associated with primary graft dysfunction and may reduce long-term recipient survival.Objective: to identify predictors of macrovesicular steatosis (>50%) by analyz...
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| Format: | Article |
| Language: | Russian |
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2022-12-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/1571 |
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| author | M. G. Minina D. V. Voronov A. A. Nevredimov E. A. Tenchurina |
| author_facet | M. G. Minina D. V. Voronov A. A. Nevredimov E. A. Tenchurina |
| author_sort | M. G. Minina |
| collection | DOAJ |
| description | Fatty liver disease (steatosis) is considered a risk factor in donor liver transplantation (LT). Macrosteatosis (>50%) is associated with primary graft dysfunction and may reduce long-term recipient survival.Objective: to identify predictors of macrovesicular steatosis (>50%) by analyzing donor characteristics.Materials and methods. The retrospective study included 525 potential liver donors between January 1, 2019 and December 31, 2020. Clinical and morphological characteristics of donors were studied using logistic regression and receiver operating characteristic (ROC) analysis. Threshold values of parameters demonstrating statistical significance in multivariate analysis as predictors of >50% hepatic steatosis were obtained by ROC analysis based on calculation of the optimal cutoff point.Results. Diabetes mellitus (DM), cause of donor’s death (traumatic brain injury), alanine transaminase (ALT) >90 units/L and aspartate transaminase (AST) >110 units/L were predictors of >50% steatosis, revealed by time-zero biopsy in the donor. Almost identical sensitivity and specificity indicators were determined in ROC analysis for liver enzymes – ALT and AST – which were 69.1 and 80.6; 72.2 and 81.1, respectively. Given the obtained values, we can say that with elevated levels of liver enzymes in the donor’s blood, there is a high degree of probability of liver parenchymal damage, but low sensitivity indicates possible multifactoriality of liver damage, and fatty liver disease may be one of the factors, but there may also be no damage to the liver parenchyma. At the same time, the rather high specificity revealed in ROC analysis for liver enzymes is a reliable sign of the absence of fatty liver disease at enzyme values less than the threshold.Conclusion. The thresholds established for ALT and AST and their corresponding levels of sensitivity and specificity indicate that these parameters have a relatively low predictive level in the context of the presence of severe fatty liver disease in a donor. This allows, nevertheless, to use models built on their basis as screening models in the primary evaluation of liver donors. |
| format | Article |
| id | doaj-art-8751fa6ccc834e4cacaa90031a62098a |
| institution | Kabale University |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2022-12-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-8751fa6ccc834e4cacaa90031a62098a2025-08-20T03:59:53ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912022-12-0124411812310.15825/1995-1191-2022-4-118-1231145Predictors of hepatic steatosis in living liver donorsM. G. Minina0D. V. Voronov1A. A. Nevredimov2E. A. Tenchurina3Botkin City Clinical Hospital; Shumakov National Medical Research Center of Transplantology and Artificial OrgansBotkin City Clinical HospitalBotkin City Clinical HospitalBotkin City Clinical HospitalFatty liver disease (steatosis) is considered a risk factor in donor liver transplantation (LT). Macrosteatosis (>50%) is associated with primary graft dysfunction and may reduce long-term recipient survival.Objective: to identify predictors of macrovesicular steatosis (>50%) by analyzing donor characteristics.Materials and methods. The retrospective study included 525 potential liver donors between January 1, 2019 and December 31, 2020. Clinical and morphological characteristics of donors were studied using logistic regression and receiver operating characteristic (ROC) analysis. Threshold values of parameters demonstrating statistical significance in multivariate analysis as predictors of >50% hepatic steatosis were obtained by ROC analysis based on calculation of the optimal cutoff point.Results. Diabetes mellitus (DM), cause of donor’s death (traumatic brain injury), alanine transaminase (ALT) >90 units/L and aspartate transaminase (AST) >110 units/L were predictors of >50% steatosis, revealed by time-zero biopsy in the donor. Almost identical sensitivity and specificity indicators were determined in ROC analysis for liver enzymes – ALT and AST – which were 69.1 and 80.6; 72.2 and 81.1, respectively. Given the obtained values, we can say that with elevated levels of liver enzymes in the donor’s blood, there is a high degree of probability of liver parenchymal damage, but low sensitivity indicates possible multifactoriality of liver damage, and fatty liver disease may be one of the factors, but there may also be no damage to the liver parenchyma. At the same time, the rather high specificity revealed in ROC analysis for liver enzymes is a reliable sign of the absence of fatty liver disease at enzyme values less than the threshold.Conclusion. The thresholds established for ALT and AST and their corresponding levels of sensitivity and specificity indicate that these parameters have a relatively low predictive level in the context of the presence of severe fatty liver disease in a donor. This allows, nevertheless, to use models built on their basis as screening models in the primary evaluation of liver donors.https://journal.transpl.ru/vtio/article/view/1571steatosisextended criteria liver donorsmetabolic associated fatty liver disease |
| spellingShingle | M. G. Minina D. V. Voronov A. A. Nevredimov E. A. Tenchurina Predictors of hepatic steatosis in living liver donors Вестник трансплантологии и искусственных органов steatosis extended criteria liver donors metabolic associated fatty liver disease |
| title | Predictors of hepatic steatosis in living liver donors |
| title_full | Predictors of hepatic steatosis in living liver donors |
| title_fullStr | Predictors of hepatic steatosis in living liver donors |
| title_full_unstemmed | Predictors of hepatic steatosis in living liver donors |
| title_short | Predictors of hepatic steatosis in living liver donors |
| title_sort | predictors of hepatic steatosis in living liver donors |
| topic | steatosis extended criteria liver donors metabolic associated fatty liver disease |
| url | https://journal.transpl.ru/vtio/article/view/1571 |
| work_keys_str_mv | AT mgminina predictorsofhepaticsteatosisinlivingliverdonors AT dvvoronov predictorsofhepaticsteatosisinlivingliverdonors AT aanevredimov predictorsofhepaticsteatosisinlivingliverdonors AT eatenchurina predictorsofhepaticsteatosisinlivingliverdonors |