Macrovesicular steatosis in living related liver donors: correlation of biopsy findings with CT liver attenuation index and body mass index.

BACKGROUND

Hepatic steatosis threatens post-transplant graft survival; therefore, pre-operative quantification of steatosis is crucial. Gold standard for evaluation is donor liver biopsy but it is invasive. An alternative non-invasive method is a calculation of CT liver attenuation index. BMI can be an independent factor predicting grade of steatosis but it is necessary to re-define appropriate BMI cut-off points that are specific for Asians.

OBJECTIVE

To retrospectively analyze CT LAI and BMI for quantitative assessment of macrovesicular steatosis in living related liver donors, using histological analysis as gold standard.

MATERIALS AND

METHODS

A radiologist blinded to histological grading calculated mean CT hepatic attenuation in 48 potential living related liver donors.

RESULTS

CT-derived LAI correctly predicted steatosis in all except 1 patient. Parametric analysis for CT LAI and BMI showed overall weak positive correlation. No significant association was found between BMI and biopsy findings.

CONCLUSION

Liver biopsy remains a gold standard for evaluation of steatosis. CT LAI of ≤0 correlates well with significant hepatic steatosis and biopsy may be avoided in such cases. Biopsy may be reserved for patients with CT LAI between 1 and 5. BMI alone is not a good predictor of hepatic steatosis in our study population.