Basic Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 18, 2015; 7(8): 1149-1153
Published online May 18, 2015. doi: 10.4254/wjh.v7.i8.1149
Normal liver stiffness: A study in living donors with normal liver histology
Ayman Alsebaey, Naglaa Allam, Khalid Alswat, Imam Waked
Ayman Alsebaey, Naglaa Allam, Imam Waked, Hepatology Department, National Liver Institute, Menoufeya University, Menoufeya 32511, Egypt
Khalid Alswat, Liver center, King Saud University, Riyadh 11461, Saudi Arabia
Author contributions: Alsebaey A performed the research; Allam N wrote the paper; Alswat K contributed research tools and contributed to the writing of the paper; Waked I supervised the study.
Ethics approval: The study was reviewed and approved by the Institutional Review Board of the National Liver Institute.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: Imam Waked is a speaker for Hoffman La Roche, MSD, BMS, GSK, Bayer, Gilead, and Minapharm, has sat on advisory boards of Janssen, Hoffman La Roche, MSD, and GSK, and has acted as investigator in clinical trials for Hoffman La Roche, BMS, GSK, Bayer, and Minapharm. All authors declare no conflicts of interest related to this work.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Naglaa Allam, MD, Hepatology Department, National Liver Institute, Menoufeya University, Shebin Al-koam, Menoufeya 32511, Egypt. naglaaallam@yahoo.com
Telephone: +20-48-2222740 Fax: +20-48-2234586
Received: December 20, 2014
Peer-review started: December 23, 2014
First decision: January 20, 2015
Revised: February 10, 2015
Accepted: April 1, 2015
Article in press: April 7, 2015
Published online: May 18, 2015
Processing time: 150 Days and 11.6 Hours
Abstract

AIM: To define the normal range of liver stiffness (LS) values using transient elastography in living-related liver transplantation candidate donors with normal liver histology.

METHODS: LS was measured using Fibroscan in 50 (16 women, 34 men) healthy potential donors (mean age 28.4 ± 5.9 years) who were being evaluated for liver donation for their relatives at the National Liver Institute, Menoufeya University, Egypt. All potential donors had normal liver tests and were negative for hepatitis B or C virus infection. Abdominal ultrasounds showed normal findings. None of the subjects had diabetes, hypertension, renal impairment, heart disease, or body mass index > 30 kg/m2. All subjects had normal liver histology upon liver biopsy. They all donated the right lobe of their liver with successful outcomes.

RESULTS: The mean LS was 4.3 ± 1.2 kPa (range: 1.8-7.1 kPa). The 5th and 95th percentiles of normal LS were 2.6 kPa and 6.8 kPa, respectively, with a median of 4 kPa; the interquartile range was 0.6 ± 0.4. LS measurements were not significantly different between men and women (4.4 ± 1.1 kPa vs 3.9 ± 1.3 kPa) and did not correlate with age. However, stiffness values were significantly lower in subjects with a body mass index < 26 kg/m2 compared to those with an index ≥ 26 kg/m2 (4.0 ± 1.1 kPa vs 4.6 ± 1.2 kPa; P <0.05). There were no differences in hospital stay or postoperative bilirubin, albumin,alanine and aspartate transaminases, or creatinine levels (at discharge) between donors with livers stiffness ≤ 4 kPa and those with stiffness > 4 kPa.

CONCLUSION: Healthy donors with normal liver histology have a median LS of 4 kPa. Stiffness values are elevated relative to increase in body mass index.

Keywords: Fibroscan; Liver stiffness; Living donors; Normal liver histology; Transient elastography

Core tip: Although some studies have measured liver stiffness by transient elastography in healthy populations, few reports evaluate these with respect to liver biopsy results. This study adds to the knowledge of liver stiffness values in clinically and histologically normal livers of an Arab population, which may form the basis for future clinical practice. The results of this study suggest a new normal level of liver stiffness for this particular population, which differs from other populations reported in the literature.