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Review
. 2021 Oct 27;13(10):1208-1214.
doi: 10.4254/wjh.v13.i10.1208.

Non-invasive real-time assessment of hepatic macrovesicular steatosis in liver donors: Hypothesis, design and proof-of-concept study

Allwyn S Rajamani  1 , Ashwin Rammohan  2 , Vv Raghavendra Sai  1 , Mohamed Rela  3
Affiliations
Review

Non-invasive real-time assessment of hepatic macrovesicular steatosis in liver donors: Hypothesis, design and proof-of-concept study

Allwyn S Rajamani et al. World J Hepatol. .

Abstract

Macrovesicular Steatosis (MS) is an independent risk factor for adverse post-liver transplant (LT) outcomes. The degree of MS is intimately related to the viability of the liver graft, which in turn is crucial to the success of the operation. An ideal liver graft should have no MS and most centres would find it unacceptable to use a donor liver with severe MS for LT. While a formal liver biopsy is the gold-standard diagnostic test for MS, given the logistical and time constraints it is not universally feasible. Other tests like a frozen section biopsy are plagued by issues of fallibility with reporting and sampling bias making them inferior to a liver biopsy. Hence, the development of an accurate, non-invasive, easy-to-use, handheld, real-time device for quantification of MS would fill this lacuna in the deceased donor selection process. We present the hypothesis, design and proof-of-concept of a study, which aims to standardise and determine the feasibility and accuracy of a novel handheld device applying the principle of diffuse reflectance spectroscopy for real-time quantification of MS.

Keywords: Deceased donors; Diffuse reflectance spectroscopy; Liver transplantation; Macrovesicular steatosis; Real-time devices.

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Conflict of interest statement

Conflict-of-interest statement: The above doctors have no conflicts of interest or financial ties to disclose.

Figures

Figure 1
Figure 1
Principle and set-up of the hand-held real time device to measure macrovesicular steatosis. A: Optoelectronics circuit, B: Handheld point of care device.
Figure 2
Figure 2
Proof-of-concept study using the prototype model of the device.
Figure 3
Figure 3
Comparison between large animal liver retrieved from abattoir and 100% fat. A: Absorbance spectrum of abattoir retrieved large animal liver and 100% fat (inset: intensity spectrums of liver and 100% fat); B: Calculated absorbance response of abattoir retrieved large animal liver and 100% fat.
Figure 4
Figure 4
Schematic representation of the proposed study design, experimental setup, and hypothesis towards the development of handheld device. It consists of reflectance probe bundle with home-made plastic block to house light emitting diode, photodetector, optoelectronic circuitry, and display. PD: Photodetector.
See this image and copyright information in PMC

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References

    1. Zhang QY, Zhang QF, Zhang DZ. The Impact of Steatosis on the Outcome of Liver Transplantation: A Meta-Analysis. Biomed Res Int . 2019;2019:3962785. - PMC - PubMed
    1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, Abraham JP, Abu-Rmeileh NM, Achoki T, AlBuhairan FS, Alemu ZA, Alfonso R, Ali MK, Ali R, Guzman NA, Ammar W, Anwari P, Banerjee A, Barquera S, Basu S, Bennett DA, Bhutta Z, Blore J, Cabral N, Nonato IC, Chang JC, Chowdhury R, Courville KJ, Criqui MH, Cundiff DK, Dabhadkar KC, Dandona L, Davis A, Dayama A, Dharmaratne SD, Ding EL, Durrani AM, Esteghamati A, Farzadfar F, Fay DF, Feigin VL, Flaxman A, Forouzanfar MH, Goto A, Green MA, Gupta R, Hafezi-Nejad N, Hankey GJ, Harewood HC, Havmoeller R, Hay S, Hernandez L, Husseini A, Idrisov BT, Ikeda N, Islami F, Jahangir E, Jassal SK, Jee SH, Jeffreys M, Jonas JB, Kabagambe EK, Khalifa SE, Kengne AP, Khader YS, Khang YH, Kim D, Kimokoti RW, Kinge JM, Kokubo Y, Kosen S, Kwan G, Lai T, Leinsalu M, Li Y, Liang X, Liu S, Logroscino G, Lotufo PA, Lu Y, Ma J, Mainoo NK, Mensah GA, Merriman TR, Mokdad AH, Moschandreas J, Naghavi M, Naheed A, Nand D, Narayan KM, Nelson EL, Neuhouser ML, Nisar MI, Ohkubo T, Oti SO, Pedroza A, Prabhakaran D, Roy N, Sampson U, Seo H, Sepanlou SG, Shibuya K, Shiri R, Shiue I, Singh GM, Singh JA, Skirbekk V, Stapelberg NJ, Sturua L, Sykes BL, Tobias M, Tran BX, Trasande L, Toyoshima H, van de Vijver S, Vasankari TJ, Veerman JL, Velasquez-Melendez G, Vlassov VV, Vollset SE, Vos T, Wang C, Wang X, Weiderpass E, Werdecker A, Wright JL, Yang YC, Yatsuya H, Yoon J, Yoon SJ, Zhao Y, Zhou M, Zhu S, Lopez AD, Murray CJ, Gakidou E. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–781. - PMC - PubMed
    1. NCD Risk Factor Collaboration (NCD-RisC) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390:2627–2642. - PMC - PubMed
    1. McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver transplantation using fatty livers: always feasible? J Hepatol. 2011;54:1055–1062. - PubMed
    1. Yersiz H, Lee C, Kaldas FM, Hong JC, Rana A, Schnickel GT, Wertheim JA, Zarrinpar A, Agopian VG, Gornbein J, Naini BV, Lassman CR, Busuttil RW, Petrowsky H. Assessment of hepatic steatosis by transplant surgeon and expert pathologist: a prospective, double-blind evaluation of 201 donor livers. Liver Transpl. 2013;19:437–449. - PubMed