Obesity, NAFLD may disqualify potential liver transplant donors

Obesity and nonalcoholic fatty liver disease (NAFLD) may disqualify potential donors from being suitable for living donor liver transplantation (LDLT), a recent study has found.

Researchers conducted a prospective analysis on 55 potential donors for an adult LDLT programme in Malaysia, as well as 33 potential recipients. Donors underwent a three-phase evaluation: clinical, anthropometric, laboratory, and liver ultrasound tests; pulmonary and cardiac assessments along with liver computed tomography; and psychological assessment along with a liver biopsy if deemed needed.

Donors had a mean age of 31.6±8.5 years and body mass index (BMI) of 25.1±4.0 kg/m². Most of them (50.9 percent) were obese and 23.6 percent were overweight; only 25.5 percent had normal BMI. In terms of hepatic steatosis, 41.5 percent had grade S3, 2.4 percent had grade S2, 19.5 percent had grade S3, and 36.6 percent had grade S1.

Following the initial evaluation, 60 percent (n=33) of the candidate donors were deemed ineligible due to comorbidities, BMI, or pregnancy. Of the 22 potential donors who underwent second-phase investigations, eight were subsequently excluded for issues related to liver anatomy.

Notably, of the 41 ineligible candidates, 21 had been rejected due to significant hepatic steatosis and seven due to high BMI. The remaining exclusions were due to nonmodifiable factors.

All remaining 14 donors passed the subsequent cardiac, pulmonary, and psychological assessments and were deemed eligible donors. Univariate analysis revealed that mean BMI was greater in those who were unsuitable for LDLT, as were obesity, dyslipidaemia, and NAFLD.