The result of weight reduction program and the risk factors for failed weight reduction in patient with fatty liver during living donor liver transplantation workup

Background To reduce both donor and recipient's risk, we have encouraged donor candidates with fatty liver to participate weight reduction program (WRP). we investigated the number of donor candidates with fatty liver and the effect of WRP, and the risk factors for failed weight reduction program (FWRP) Method We reviewed medical record of donor candidates who received liver donation work up between June of 2011 and June of 2017. MRI is used for the decision for undergoing a biopsy and measuring of fat fraction. We routinely performed liver biopsy during living donor surgeryand compared to preoperative MR fat fraction. The ‘failed weight reduction program (FWRP)’ defined that the donor’s fat fraction has not been reduced to less than 5% or fat fraction was more than 50% of initial fat fraction in biopsy. And we analyzed the risk factor for FWRP. A total 1307 donor candidate received general examination for liver donation between June of 2011 and June of 2017. One hundred thirty one(10,0%) candidates went on a diet for weight reduction. Twenty-three (20.5%) donors were FWRP. We analyzed risk factors comparing two groups, patient achieved success of WRP and FWRP group. The mean duration for WRP was 72 ± 115 days and mean value of the difference of body weight between before and after WRP was 3.5 ± 4.4. In demographics, there were no significantly different characteristics including age, gender, initial body weight, BMI, laboratory findings, BMI, body weight difference except initial MR fat fraction. In multivariate analysis, initial MR fat fraction more than 10% was significant factor [OR 7.314 (2.144 – 24.950), =0.001] for FWRP Conclusion Short-term WRP can improve donor’s fatty liver profile. If the MR fat fraction is more than 10%, we need to concern for weight reduction during WRP