Journal of Clinical Gastroenterology and Hepatology Open Access

Is it possible to predict liver steatosis in liver transplantation using liver to spleen attenuation ratio and BMI?

6^th Annual European Conference on Gastroenterology

June 19-20, 2018 Paris, France

Ahmed Swelam, Marc Antoine Allard, Sherif ElGarf1, Eric Vibert, Gabriella Pittau, Antonio SaCuhna, Danie Cherqui, Denis Castaing and Rene Adam

Tanta University, Egypt
South Paris university, France

Posters & Accepted Abstracts: J Clin Gastroenterol Hepatol

Abstract:

Introduction: Severe macrovesicular steatosis (MaS) in liver graft is widely considered as a contraindication for liver transplant. This study aimed to assess the value of liver to spleen (L/S) ratio measured on CT scan and donor body mass index (BMI) to predict severe MaS Patient & Method: From January 2012 to August 2015, L/S ratio was measured in 213 brain death donors by local radiologists. Liver biopsy was systematically performed during procurement, allowing histological evaluation of steatosis. Severe MaS was defined as a percentage of steatosis > 60% validated by expert pathologists. Results: Severe Mas was found in 6 (3%). L/S ratio was significantly associated with severe MaS (area under curve AUC: 0.80) L/ S<0.9 best predict severe MaS .The donor BMI was also associated with severe MaS (AUC: 0.79) with an optimal curoff value 30 kg/m2. The donor age and sex as well as liver function test were not associated with significant MaS. On multivariate analysis L/S ratio<0.9 (RR: 15.4 [2.03-305.6] p=0.01) and BMI>30 kg/m2 (RR: 6.49 [1.13-50.4] p=0.03) remained independent predictors of sever MaS. The resulting probability of severe MaS was respectively 0%,2%,5%,and24% in the absence of any factor, in the presence of BMI>30 kg/m2 only, in the presence of L/S ratio< 0.9 and in the presence of both predictors. Conclusion: L/S <0.9 and BMI>30 kg/m2 predict severe MaS. Liver biopsy before procurement should be considered in donors presenting bboth factors