Usefulness of Preoperative Magnetic Resonance Spectroscopy to Improve the Safety of a Living Liver Donor.

Objectives: The steatosis of graft liver is an important factor in liver transplant that determines the graft function in the recipient and the recovery of the remnant liver in the living donor. We analyzed the data of living donors from our center to evaluate whether magnetic resonance imaging and magnetic resonance spectroscopy can replace liver biopsy.

Materials And Methods: From May 2010 to May 2019, data from a total of 239 living donors was collected. There were 84 patients who had no magnetic resonance imaging or magnetic resonance spectroscopy data, and they were excluded. The result of preoperative liver biopsy was compared with preoperative magnetic resonance imaging and magnetic resonance spectroscopy data. The steatosis was defined by the degree of macrosteatosis.

Results: The magnetic resonance imaging of the fat fraction was a good parameter to predict fatty changes between normal and fatty liver groups (3.09 ± 3.38% for normal 7.48 ± 4.07% for fatty liver; P < .001). The magnetic resonance spectroscopy was also a good parameter to predict fatty changes between normal and fatty liver groups (2.09 ± 1.43% for normal and 6.89 ± 2.68% for fatty liver; P < .001). Linear regression showed that pathology results were significantly correlated with magnetic resonance spectroscopy (P < .001, R2 = 0.604) but not with magnetic resonance imaging (P < .001, R2 = 0.227).

Conclusions: Magnetic resonance spectroscopy has several benefits for quantifying hepatic steatosis during a living donor liver transplant evaluation, including no radiation exposure, and a noninvasive procedure. Moreover, preoperative magnetic resonance spectroscopy can determine an anatomic variation of the bile duct, which helps improve the safety of the living donor. However, more clinical data and further studies are needed to ensure that preoperative magnetic resonance spectroscopy is essential.