Mild hepatic macrovesicular steatosis may be a risk factor for hyperbilirubinaemia in living liver donors following right hepatectomy

Abstract

Background: The aim of this study was to evaluate the effects of mild macrovesicular steatosis on the outcome of living liver donors following right hepatectomy. Methods: The medical records of 46 living liver donors who underwent right hepatectomy were studied. Ten donors had mild macrovesicular steatosis (5-10 per cent in seven and 11-20 per cent in three patients). Five donors with other liver pathology were excluded. Outcome in these ten donors (group 1) was compared with that in the remaining 31 donors with normal liver histology (group 2). Results: The median duration until normalization of total bilirubin levels was 14 and 5 days in groups 1 and 2 respectively (P = 0·028). The peak total bilirubin level was significantly higher in group 1 than in group 2 (80·4 versus 49·6 μmol/l; P = 0·033).Multivariable analysis showed mild macrovesicular steatosis to be an independent risk factor for hyperbilirubinaemia (odds ratio 7·94 (95 per cent confidence interval 1·17 to 54·03); P = 0·034). Conclusion: Mild macrovesicular steatosis may be related to adverse outcome in living liver donors who undergo right hepatectomy and, in terms of donor safety, is of potential concern in donor selection. © 2009 British Journal of Surgery Society Ltd.