Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Standard liver weight model in adult deceased donors with fatty liver: A prospective cohort study
Bo Li, Pan-Yu Chen, Yi-Fei Tan, He Huang, Min Jiang, Zhen-Ru Wu, Chen-Hao Jiang, Dao-Feng Zheng, Diao He, Yu-Jun Shi, Yan Luo, Jia-Yin Yang
Bo Li, Yi-Fei Tan, Chen-Hao Jiang, Dao-Feng Zheng, Diao He, Jia-Yin Yang, Department of Liver Surgery, Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Bo Li, Yi-Fei Tan, Chen-Hao Jiang, Dao-Feng Zheng, Diao He, Jia-Yin Yang, Laboratory of Liver Transplantation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Pan-Yu Chen, Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
He Huang, Yan Luo, Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Min Jiang, Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Zhen-Ru Wu, Yu-Jun Shi, Laboratory of Pathology, Key Laboratory of Transplant Immunology and Engineering, National Health Commission, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Li B and Chen PY contributed equally to this work; Li B collected all the clinical data, analyzed the data, drafted the manuscript and prepared the revised materials; Chen PY collected the data of donor liver weight in the operating room and assisted with data analysis; Tan YF analyzed the data, drafted the manuscript and prepared the revised materials; Huang H and Luo Y assisted with ultrasound examination and data processing; Wu ZR and Shi YJ helped with tissue staining and histological assessment; Zheng DF, He D and Jiang CH assisted with donor liver weight measurement and tissue Sampling; Jiang M participated in design of the study, data processing and data analysis; Yang JY participated in design and oversight of the study and was involved with drafting of the manuscript; all authors have read and approve the final manuscript.
Supported by New Clinical Technology Project, West China Hospital, Sichuan University, No. 20HXJS012; and National Natural Science Foundation of China, No. 81770653 and No. 82070674.
Institutional review board statement: This study was reviewed and approved by the West China Hospital of Sichuan University Institutional Review Board.
Clinical trial registration statement: This study was registered at
http://www.chictr.org.cn. The registration identification number is ChiCTR2000041406.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Jia-Yin Yang, MD, PhD, Chief Doctor, Director, Professor, Surgeon, Department of Liver Surgery, Liver Transplantation Centre, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. doctoryjy@scu.edu.cn
Received: June 20, 2021
Peer-review started: June 20, 2021
First decision: August 8, 2021
Revised: August 22, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: October 21, 2021
ARTICLE HIGHLIGHTS
Research background
Standard liver weight (SLW) is frequently used in liver transplantation, especially for living donor liver transplantation/split liver transplantation (SLT). However, some deceased donors (DDs) have fatty liver (FL). There have been a few studies to report that FL could impact liver size. This study was to develop a new formula including FL to predict liver size.
Research motivation
To explore SLW model in adult DDs with FL and help transplant doctors make allocation decisions, especially for recipients assigned with FL in SLT to reduce the risk of small-for-size syndrome.
Research objectives
To explore the liver pathology of DDs, such as hepatic steatosis, and diagnostic ability of ultrasound for FL, as well as the relationship between FL and total liver weight. Furthermore, to develop an SLW formula, combined with FL parameter, used to predict graft weight required for recipients in SLT.
Research methods
This study prospectively enrolled consecutive DDs from West China Hospital of Sichuan University from June 2019 to February 2021 and recorded basic patient information, and abdominal ultrasound (US) examination and pathological biopsy (PB) were performed for them. Furthermore, the chi-square test and kappa consistency score were used to assess the consistency in terms of FL diagnosed by US relative to PB. Simple linear regression analysis was used to explore the variables related to TLW. Multiple linear regression analysis was used to formulate SLW models.
Research results
More than a quarter of DDs had hepatic steatosis, and US had a high diagnostic ability for mild to severe FL. Furthermore, this study found that FL was positively correlated with liver size and deduced an optimal SLW formula in adult DDs with FL. However, the extrapolation and clinical practicability of the current SLW model need to be further verified in the future.
Research conclusions
FL is positively correlated with liver size. Our novel formula deduced using sex, BSA and FLUS is the optimal formula for predicting SLW in adult DDs with FL.
Research perspectives
To verify the extrapolation of the current SLW model using multicentre data and its clinical practicability in SLT.
