Is Fibroscan Essential for Assessment of Living Liver Donor Candidates?

Purpose: As living liver donor transplantation continues to grow, noninvasive methods to determine intrinsic liver disease will become paramount during donor evaluation. We hypothesize that Fibroscan provides a safe and cost-effective approach to donor assessment.

Materials and Methods: Potential donors evaluated in the last year were included. Suitable candidates entered the clinical assessment phase in which laboratory, and Fibroscan data were collected. Fibroscan involves transient elastography (TE), acoustic radiation force impulse (ARFI), and controlled attenuation parameter (CAP) score assessments.

Results: Fifty potential donors entered into preliminary screening from which 18 proceeded to laboratory and detailed demographic assessment, followed by 11 undergoing Fibroscan. Mean age was 34.9 (range: 19–47), 7 females, six assessed for adult to adult donation (54%), 4 for adult to pediatric (36%), with one nondirected/unrelated (9%). Fibroscan results were 4.9 ± 0.8 kPa, 1.28 ± 0.12 m/s, and 233.5 ± 67.9 for TE, ARFI, and CAP score, respectively. Six patients had abnormal results, five of them had grade S1 (n = 1) or S3 (n = 4) steatosis, and one had evidence of fibrosis. Liver function tests (LFT) were within normal limits in all but one of them.

Conclusion: Fibroscan could improve selection of potential living liver donors, as LFTs might be normal during early stages of liver disease. More than half of our donors evaluated this year had abnormal Fibroscans and were referred for lifestyle interventions and follow-up with hepatology. Our project includes the use of this technology in the follow-up of the donors and grafts transplanted.

No conflict of interest has been declared by the author(s).