Weight loss interventions in living donor liver transplantation as a tool in expanding the donor pool: A systematic review and meta-analysis

Table 1 Overview of interventions used for body mass index and steatosis reduction, and donor, recipient and graft outcomes following liver transplantation

Study number	Ref.	n	Type of intervention	Treatment duration	BMI reduction	Steatosis reduction	Liver donation	Donor, graft, recipient outcomes
1	Fujii et al[15], 2020	8	< 1600 Kcal/d + exercise 20 min x 3/wk ± statins	Median of 58 d	Yes (P = 0.0009)	Yes (P = 0.0006)	8	No significant difference from controls
2	Doyle et al[16], 2016	16	Optifast VLCD: 1000 kcal/ d	Median of 7.3 wk	Yes (P < 0.001)	Yes (P < 0.001)	14 (1 inadequate volume, 1 fibrosis)	No significant difference from controls
3	Choudhary et al[17], 2015	16	1200 kcal/d + 200 to 400 kcal/d exercise ± statins	Mean 28 ± 10 d	Yes (P = 0.006)	Yes (P = 0.008)	14 (2 had NASH/fibrosis)	No reported complication in perioperative period
4	Oshita et al[18], 2012	42	800 to 1400 kcal/d diet + 100 to 400 kcal/d exercise	Median 2.9 mo	Yes (P < 0.0001)	Yes, to < 20 %	41 (1 had stage 2 fibrosis)	No different from control group
5	Nakamuta et al[19], 2005	11	1000 kcal/d diet + exercise (600 kcal/d) + Bezafibrate	Mean 37.8 ± 4.6 d	Yes(P = 0.0033)	Yes(P= 0.0028)	7 (2 recipient deaths, 1 inadequate GRWR)	No different from control group
6	Hwang et al[20], 2004	9	Diet (25-30 calories x ideal body weight) + exercise	Median of 3 mo	Yes (P = 0.0001)	Yes (P = 0.006)	9	No different from control group

BMI: Body mass index; GRWR: Graft weight/recipient weight ratios; NASH: Nonalcoholic steatohepatitis; VLCD: Very low calorie diet.