Comparing computerized tomography indices and liver biopsy in liver transplantation donors for hepatosteatosis

Background: Selecting the right donor to achieve a successful liver transplantation is very important; thus computerized tomography and liver biopsy are frequently applied in the diagnosis of steatosis in donors.
Purpose: We sought to investigate the efficacy of computerized tomography in the evaluation of hepatosteatosis in living donor liver transplantation donors.
Material and methods: The living donor liver transplantation cases between January 2015 and December 2017 were screened retrospectively. The study participants were divided into three groups according to the degree of steatosis determined during LB as follows: grade 0: less than 5%, grade 1: 6% to 20%, and grade 2: greater than 20%. Using computerized tomography scans, hepatic attenuation value (CT^L), hepatic attenuation value and spleen attenuation value ratio (CT^L/S), and the difference between hepatic attenuation value and splenic attenuation values (CT^L−S) were determined and the correlations of these indices and the findings of LB were compared.
Results: Of the 60 patients (42 males, mean age: 32.4±7.7 years), 43 had grade 0, 15 had grade 1, and two had grade 2 hepatosteatosis, respectively. The CT^L, CT^L/S, and CT^L−S cutoff values were 48.3, 1.06, and 3.2, respectively, while the sensitivity and specificity results of these cutoff values were 64.7% and 88.3%, 64.7% and 86%, and 64.7% and 86% and the area under the curve values were determined to be 0.81, 0.79, and 0.80 (p< 0.001).
Conclusion: The use of these noninvasive indices can reduce the need for liver biopsy, which is an invasive procedure, as well as lessen the associated complication and cost rates. Future prospective studies are needed on this subject.