Hepatic steatosis in liver transplant donors: rare phenomenon or common feature of donor population?

AIM: The aim of this research was a histopathological assessment of cadaveric donor liver steatosis including: the degree (percent of involved hepatocytes) and type size of vacuoles showing fatty change by various histologic techniques.
MATERIALS AND METHODS: The study included 70 donor livers. Hematoxylin-eosin and Sudan III staining methods were used for the examination. The degree of steatosis was assessed according to the Dixon scale with the type of fatty degeneration classified into three steatotic patterns.
RESULTS: Steatosis was observed in 36/70 donor livers (51.4%) including those from 23 male (64%) and 13 female (36%) patients. The mean age of the steatotic donors was 53.7 years in contrast to the nonsteatotic donors of 45.3 years. Mild steatosis was identified in five of all sections (7.1%); mild focal and moderate zonal steatosis in 10 (14.3%), and severe, panlobular steatosis in 11 (15.3%). Fatty liver was observed as the only microscopic feature in nine cases (13%), in combination with cholestasis in 2 (2.8%); with inflammation in 5 (7%); and together with inflammation, fibrosis, and cholestasis in 20 (29%). Three types of steatotic pattern were shown: (1) small-droplet lipid vacuolization (microsteatosis) in 7/36 cases (19%); (2) large and small fat drops (macromicrosteatosis) in 8/36 (22%); and (3) typical macrosteatosis in 21/36 (59%) cases.
CONCLUSIONS: Moderate to severe steatosis is a quite frequent finding in donor livers. Donor livers with 1(0) or 2(0) steatosis as the only pathological feature can be successfully used in orthotopic liver transplantation.