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. 2024 Aug 23;8(8):e70015.
doi: 10.1002/jgh3.70015. eCollection 2024 Aug.

Steatosis, inflammation, fibroprogression, and cirrhosis in remnant liver post-liver donation

Jeby Jacob  1 , Amal Joseph  2 , Harikumar R Nair  2 , Geevarghese Prajob Prasad  1 , Vijosh V Kumar  1 , Lekshmi Thattamuriyil Padmakumari  3
Affiliations

Steatosis, inflammation, fibroprogression, and cirrhosis in remnant liver post-liver donation

Jeby Jacob et al. JGH Open. .

Abstract

Background and aim: This is a cross-sectional observational study conducted on living liver donors focusing on "long-term remnant liver health" specifically looking at steatosis, inflammation, and fibrosis using multiparametric ultra sonological evaluation and noninvasive blood tests.

Methods: Multiparametric ultrasound evaluation included assessment of shear wave elastography (fibrosis), sound speed plane wave ultrasound, attenuation plane wave ultrasound (steatosis), and viscosity plane wave ultrasound (inflammation). Blood test based APRI and FIB-4 were calculated. Liver biopsy was performed if noninvasive evaluation pointed toward clinically relevant fibro progression (F4).

Results: Out of 36 donors, significant fibrosis (>F2) was found in 11 donors (30.5%), seven donors (19.4%) had severe fibrosis (>F3), and two donors had shear wave elastography values suggestive of cirrhosis(F4). Of these two, one donor was extensively evaluated and was found to have biopsy proven cirrhosis with endoscopic evidence of portal hypertension. The prevalence of fatty liver disease in our study group was 50%.

Conclusion: We report the first liver donor cohort with fibroprogression and cirrhosis occurring in the remnant liver. Our donor cohort with a significant proportion having steatosis and fibroprogression underscores the importance of regular follow-up of liver donors and evaluation of remnant liver.

Keywords: cirrhosis; fatty liver; non alcoholic fatty liver disease.

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Figures

Figure 1
Figure 1
Axial computerized tomographic section of upper abdomen in venous phase. The remnant liver shows altered attenuation with surface appearing irregular with multiple regenerative nodules.
Figure 2
Figure 2
(a) Liver biopsy: Periodic Acid Schiff (PAS) stained section (50×)—Hepatocytes showing PAS positivity arranged in the form of nodules with widened portal tracts. (b) Masson's Trichrome (MT) stained section (100×) highlighting architectural distortion with hepatocytes arranged in nodular form and fibrotic bands.
See this image and copyright information in PMC

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