Sahin Tolga, Arikan Bahadir Turkmen, Serin Ayfer, Emek Ertan, Bozkurt Birkan, Server Sadik, Dibekoglu Cengiz, Tokat Yaman
Sisli Florence Nightingale Hospital, Liver Transplantation Institute, Hospital of Istanbul Bilim University, Istanbul, Turkey.
Sisli Florence Nightingale Hospital, Liver Transplantation Institute, Hospital of Istanbul Bilim University, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2383-2386. doi: 10.1016/j.transproceed.2019.01.177. Epub 2019 Aug 8.
The degree of liver steatosis is an important factor for donor selection in living donor liver transplantation. Multidetector computed tomography (MDCT) has long been used in many transplantation centers to determine donor liver steatosis. Noninvasive scoring methods based on laboratory tests have been investigated as potential methods for altering liver biopsy and imaging techniques in evaluating the liver steatosis. In this study, we assess the utility of several noninvasive methods for the evaluation of donor hepatosteatosis. In comparison, MDCT was used for the evaluation of liver steatosis.
A total of 205 donor candidates with significant hepatosteatosis were included in the study and divided into 4 groups according to the degrees of steatosis as measured by MDCT (mild, mid- to moderate, moderate to severe, and severe). In comparison, the aspartate aminotransferase-platelet ratio index (APRI), nonalcoholic fatty liver disease fibrosis score, BARD score, and FIB-4 scores were calculated.
The diagnostic performance of APRI in prediction of all degrees of hepatosteatosis on MDCT was significantly higher (P < .01). The BARD score showed the second best performance (P = .018), whereas FIB-4 and nonalcoholic fatty liver disease fibrosis score were not correlated with degree of liver steatosis on MDCT.
Some noninvasive scoring methods including APRI and BARD score seem to be more beneficial for the detection of hepatic steatosis in donor candidates and may reduce the need for other invasive and expensive diagnostic techniques.
肝脂肪变性程度是活体肝移植供体选择的重要因素。多排螺旋计算机断层扫描（MDCT）长期以来一直在许多移植中心用于确定供体肝脏脂肪变性。基于实验室检查的非侵入性评分方法已被研究作为改变肝活检和成像技术以评估肝脏脂肪变性的潜在方法。在本研究中，我们评估了几种非侵入性方法在评估供体肝脂肪变性中的效用。作为对照，MDCT用于评估肝脏脂肪变性。
本研究共纳入205例有明显肝脂肪变性的供体候选人，并根据MDCT测量的脂肪变性程度分为4组（轻度、中至中度、中度至重度和重度）。作为对照，计算天冬氨酸转氨酶-血小板比率指数（APRI）、非酒精性脂肪性肝病纤维化评分、BARD评分和FIB-4评分。
APRI对MDCT上所有程度肝脂肪变性的诊断性能显著更高（P <.01）。BARD评分表现次之（P =.018），而FIB-4和非酒精性脂肪性肝病纤维化评分与MDCT上的肝脏脂肪变性程度无关。
包括APRI和BARD评分在内的一些非侵入性评分方法似乎对检测供体候选人的肝脂肪变性更有益，并且可能减少对其他侵入性和昂贵诊断技术的需求。
