Liver biopsy findings from healthy potential living liver donors

Reasons for disqualification, silent diseases and correlation with liver injury tests

Marta I. Minervini, Kristine Ruppert, Paulo Fontes, Riccardo Volpes, Giovanni Vizzini, Michael E. de Vera, Salvatore Gruttadauria, Roberto Miraglia, Loredana Pipitone, J. Wallis Marsh, Amadeo Marcos, Bruno Gridelli, Anthony J. Demetris

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background/Aims: Liver biopsies detect silent donor disease in potential living liver donors and provide material for studies of subclinical non-alcoholic fatty liver disease (NAFLD). Our primary goal was to determine the contribution of biopsy findings to potential donor evaluation. Factors contributing to pre-clinical NAFLD and correlations between liver injury tests and histopathology have been also determined. Methods: Patient records, laboratory tests and results of the histopathologic examination and diagnoses of 284 patients from 2001 to 2005 were retrospectively extracted from the EDIT database. Hepatic histology was correlated with liver injury tests and with general demographic characteristics in an otherwise normal healthy population. Results: A minority (n = 119; 42%) of biopsies from this population of 143 males/141 females (average age = 36.8 years; mean BMI = 26.6) were completely normal. The remainder showed steatosis (n = 107; 37%), steatohepatitis (n = 44; 15%), or unexplained low-grade/early stage chronic hepatitis, primary biliary cirrhosis, or nodular regenerative hyperplasia (n = 16; 6%). Biopsy findings disqualified 29/56 donors. Independent risk factors for NAFLD by multivariate modeling, which differed by sex, included: BMI (p = 0.0001), age (p = 0.003), iron (p = 0.01), and ALT (p = 0.004). Conclusions: Liver biopsies provide valuable information about otherwise undetectable liver disease in potential liver donors. Obesity, age and iron, which are influenced by sex, contribute to NAFLD pathogenesis. Blood tests other than standard liver profiles are needed to detect early NAFLD.

Original languageEnglish
Pages (from-to)501-510
Number of pages10
JournalJournal of Hepatology
Volume50
Issue number3
DOIs
Publication statusPublished - Mar 2009

Fingerprint

Living Donors
Biopsy
Liver
Wounds and Injuries
Tissue Donors
Iron
Biliary Liver Cirrhosis
Hematologic Tests
Fatty Liver
Chronic Hepatitis
Population
Hyperplasia
Liver Diseases
Histology
Obesity
Demography
Non-alcoholic Fatty Liver Disease
Databases

Keywords

  • Liver injury tests
  • Living donor liver biopsy
  • Non-alcoholic fatty liver disease
  • Steatohepatitis
  • Transplantation

ASJC Scopus subject areas

  • Hepatology

Cite this

Liver biopsy findings from healthy potential living liver donors : Reasons for disqualification, silent diseases and correlation with liver injury tests. / Minervini, Marta I.; Ruppert, Kristine; Fontes, Paulo; Volpes, Riccardo; Vizzini, Giovanni; de Vera, Michael E.; Gruttadauria, Salvatore; Miraglia, Roberto; Pipitone, Loredana; Marsh, J. Wallis; Marcos, Amadeo; Gridelli, Bruno; Demetris, Anthony J.

In: Journal of Hepatology, Vol. 50, No. 3, 03.2009, p. 501-510.

Research output: Contribution to journalArticle

Minervini, Marta I. ; Ruppert, Kristine ; Fontes, Paulo ; Volpes, Riccardo ; Vizzini, Giovanni ; de Vera, Michael E. ; Gruttadauria, Salvatore ; Miraglia, Roberto ; Pipitone, Loredana ; Marsh, J. Wallis ; Marcos, Amadeo ; Gridelli, Bruno ; Demetris, Anthony J. / Liver biopsy findings from healthy potential living liver donors : Reasons for disqualification, silent diseases and correlation with liver injury tests. In: Journal of Hepatology. 2009 ; Vol. 50, No. 3. pp. 501-510.
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abstract = "Background/Aims: Liver biopsies detect silent donor disease in potential living liver donors and provide material for studies of subclinical non-alcoholic fatty liver disease (NAFLD). Our primary goal was to determine the contribution of biopsy findings to potential donor evaluation. Factors contributing to pre-clinical NAFLD and correlations between liver injury tests and histopathology have been also determined. Methods: Patient records, laboratory tests and results of the histopathologic examination and diagnoses of 284 patients from 2001 to 2005 were retrospectively extracted from the EDIT database. Hepatic histology was correlated with liver injury tests and with general demographic characteristics in an otherwise normal healthy population. Results: A minority (n = 119; 42{\%}) of biopsies from this population of 143 males/141 females (average age = 36.8 years; mean BMI = 26.6) were completely normal. The remainder showed steatosis (n = 107; 37{\%}), steatohepatitis (n = 44; 15{\%}), or unexplained low-grade/early stage chronic hepatitis, primary biliary cirrhosis, or nodular regenerative hyperplasia (n = 16; 6{\%}). Biopsy findings disqualified 29/56 donors. Independent risk factors for NAFLD by multivariate modeling, which differed by sex, included: BMI (p = 0.0001), age (p = 0.003), iron (p = 0.01), and ALT (p = 0.004). Conclusions: Liver biopsies provide valuable information about otherwise undetectable liver disease in potential liver donors. Obesity, age and iron, which are influenced by sex, contribute to NAFLD pathogenesis. Blood tests other than standard liver profiles are needed to detect early NAFLD.",
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T2 - Reasons for disqualification, silent diseases and correlation with liver injury tests

AU - Minervini, Marta I.

AU - Ruppert, Kristine

AU - Fontes, Paulo

AU - Volpes, Riccardo

AU - Vizzini, Giovanni

AU - de Vera, Michael E.

AU - Gruttadauria, Salvatore

AU - Miraglia, Roberto

AU - Pipitone, Loredana

AU - Marsh, J. Wallis

AU - Marcos, Amadeo

AU - Gridelli, Bruno

AU - Demetris, Anthony J.

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N2 - Background/Aims: Liver biopsies detect silent donor disease in potential living liver donors and provide material for studies of subclinical non-alcoholic fatty liver disease (NAFLD). Our primary goal was to determine the contribution of biopsy findings to potential donor evaluation. Factors contributing to pre-clinical NAFLD and correlations between liver injury tests and histopathology have been also determined. Methods: Patient records, laboratory tests and results of the histopathologic examination and diagnoses of 284 patients from 2001 to 2005 were retrospectively extracted from the EDIT database. Hepatic histology was correlated with liver injury tests and with general demographic characteristics in an otherwise normal healthy population. Results: A minority (n = 119; 42%) of biopsies from this population of 143 males/141 females (average age = 36.8 years; mean BMI = 26.6) were completely normal. The remainder showed steatosis (n = 107; 37%), steatohepatitis (n = 44; 15%), or unexplained low-grade/early stage chronic hepatitis, primary biliary cirrhosis, or nodular regenerative hyperplasia (n = 16; 6%). Biopsy findings disqualified 29/56 donors. Independent risk factors for NAFLD by multivariate modeling, which differed by sex, included: BMI (p = 0.0001), age (p = 0.003), iron (p = 0.01), and ALT (p = 0.004). Conclusions: Liver biopsies provide valuable information about otherwise undetectable liver disease in potential liver donors. Obesity, age and iron, which are influenced by sex, contribute to NAFLD pathogenesis. Blood tests other than standard liver profiles are needed to detect early NAFLD.

AB - Background/Aims: Liver biopsies detect silent donor disease in potential living liver donors and provide material for studies of subclinical non-alcoholic fatty liver disease (NAFLD). Our primary goal was to determine the contribution of biopsy findings to potential donor evaluation. Factors contributing to pre-clinical NAFLD and correlations between liver injury tests and histopathology have been also determined. Methods: Patient records, laboratory tests and results of the histopathologic examination and diagnoses of 284 patients from 2001 to 2005 were retrospectively extracted from the EDIT database. Hepatic histology was correlated with liver injury tests and with general demographic characteristics in an otherwise normal healthy population. Results: A minority (n = 119; 42%) of biopsies from this population of 143 males/141 females (average age = 36.8 years; mean BMI = 26.6) were completely normal. The remainder showed steatosis (n = 107; 37%), steatohepatitis (n = 44; 15%), or unexplained low-grade/early stage chronic hepatitis, primary biliary cirrhosis, or nodular regenerative hyperplasia (n = 16; 6%). Biopsy findings disqualified 29/56 donors. Independent risk factors for NAFLD by multivariate modeling, which differed by sex, included: BMI (p = 0.0001), age (p = 0.003), iron (p = 0.01), and ALT (p = 0.004). Conclusions: Liver biopsies provide valuable information about otherwise undetectable liver disease in potential liver donors. Obesity, age and iron, which are influenced by sex, contribute to NAFLD pathogenesis. Blood tests other than standard liver profiles are needed to detect early NAFLD.

KW - Liver injury tests

KW - Living donor liver biopsy

KW - Non-alcoholic fatty liver disease

KW - Steatohepatitis

KW - Transplantation

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