Resolution of Severe Graft Steatosis Before Living-Donor Liver Transplant After 86 Pounds of Weight Loss

UMMS Affiliation

Department of Surgery, Transplant Division; Department of Pathology; Department of Medicine, Division of Gastroenterology

Publication Date


Document Type



Digestive System Diseases | Gastroenterology | Surgery | Surgical Procedures, Operative


Living-donor liver transplant allows for expedited transplant, with outcomes shown to be superior compared with deceased-donor liver transplant due to earlier intervention, with reduced hospital costs. However, they only comprise about 5% of liver transplants nationally. This is due to a limited pool of willing donors and donor exclusions for medical and psycho-social reasons. The leading reason for why potential living liver donors are not eligible is nonalcoholic fatty liver disease. Donor hepatic steatosis limits the number of potential living-donor liver transplants because it is associated with perioperative complications in both donors and recipients. Here, we describe a 37-year-old male potential living donor who presented with hepatic steatosis based on preoperative imaging. Over a 1-year period, he was able to completely reverse his hepatic steatosis by losing about 86 pounds (from 279 to 193 pounds), reducing his body mass index from 40 to 28.55 kg/m(2). Computed tomography and biopsy results after his weight loss showed that he had no hepatic steatosis, allowing him to become a living donor for his mother. Postoperative periods for both the donor and recipient were uncomplicated. This case suggests that the pool of living liver donors could be expanded through dietary and behavior modifications, thus increasing the number of potential living donors and providing potential recipients with more transplant options. Enlarging this pool of donors will also improve transplant outcomes for donors and recipients and lower overall health care costs compared with deceased-donor liver transplant.


Allocation, Complications, Contraindications, Donor selection, Liver transplant, Non-alcoholic fatty liver disease

DOI of Published Version



Roubil JG, Martins PN, Babak M, Bledsoe J, Bludevich BM, Barry C, Bozorgzadeh A. Resolution of Severe Graft Steatosis Before Living-Donor Liver Transplant After 86 Pounds of Weight Loss. Exp Clin Transplant. 2020 Aug 7. doi: 10.6002/ect.2019.0423. Epub ahead of print. PMID: 32778015. Link to article on publisher's site

Journal/Book/Conference Title

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation

Related Resources

Link to Article in PubMed

PubMed ID