Expanding Donor Pool for Live Donor Liver Transplantation: Utilization of Donors With NASH After Optimization
Condition: Non Alcoholic Steatohepatitis
MeSH terms: Fatty Liver; Non-alcoholic Fatty Liver Disease
Study type: Observational

Summary: 
      Live donor liver transplantation (LDLT) is the treatment of choice for end-stage liver
      disease, predominantly in the East, where deceased donor liver transplantation is sparse. In
      LDLT, donor selection has to be stringent; as the donor safety is thepriority. Live liver
      donors (LLD) with complex biliary and vascular anatomy are increasingly being accepted for
      donation with the betterment of technical expertise. One of the commonest reasons for LLD
      rejection is the hepatic parenchymal abnormality because ofsteatosis and steatohepatitis,
      which can increase the donor risk. Retrospective analysis of donors with non-alcoholic
      steatohepatitis(NASH) who were optimized and taken up for major hepatectomy from June 2011 to
      January 2018will be performed.
    

Detailed description: 
      Study Design Aim and Objective -

        -  Primary objective:

        -  To study the effect of donor optimization protocol in donors with biopsy proven NASH

        -  To study thebiochemical (LFTSs & INR) recovery in donors with NASH after major
           hepatectomy

        -  To compare their biochemical recovery parameters (LFTs & INR) with that of non NASH
           donors.

        -  Secondary objectives:

        -  To study incidence of NASH among live liver donors

        -  To study their respective recipients' outcomes

        -  To study the morbidity among LLDs with NASH after major hepatectomy

      Methodology:

        -  Study population:Patients underwentLDLT from June 2011 to January 2019 at Institute of
           Liver & Biliary Sciences, New Delhi

        -  Study design:Retrospective study

        -  Study period:from June 2011 to January 2019

        -  Sample size with justification:All consecutive LLDs with at least one year of follow up
           post-operatively

        -  Intervention: none

        -  Monitoring and assessment:none Statistical Analysis:Categorical variables were presented
           as number (percentage) and were compared using the Chi-square test. Continuous variables
           were presented as mean (standard deviation, SD) and were compared using Mann-Whitney U
           Test.

      Adverse Effects: None Stopping Rule of Study: None

      Expected Outcome of the Project: Adherence to a strict dietary and lifestyle modifications
      plan will cause histological reversal of NASH and fibrosis in LLDs. Their clinical and
      biochemical recovery following the major hepatectomy will be similar to that of non-NASH
      LLDs.
    

Intervention name(s): No Intervention
Intervention type(s): Other
Intervention description(s): No Intervention
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Patients underwent LDLT from June 2011 to January 2019 at Institute of Liver & Biliary
        Sciences, New Delhi