BACKGROUND: Clinical demand for liver transplant steadily grows while organs offer has reached a plateau years ago. To expand the donor liver pool, various options have been considered including acceptance of suboptimal donors and steatotic grafts, with a risk of poorer outcomes. The latter risk and its relation to the grade of liver graft steatosis have been studied in this prospective clinical study. METHODS: One hundred eighteen consecutive liver transplantation (115 patients) performed between May 2002 and March 2008 were prospectively analyzed. According to the grade of steatosis on a 2 hr postreperfusion biopsy, four groups were considered: absence (<5%) (n=34), mild (<30%) (n=40), moderate (30%-60%) (n=23), or severe steatosis (> or = 60%) (n=21). Donors and recipients demographic data, and patients and grafts survival rates were compared among the four groups. RESULTS: Eighty-four (71%) grafts presented some degree of steatosis (macrosteatosis: 19.5%, microsteatosis: 47%, mix type: 33.5%). Patient and graft survival were significant lower in the "severe steatosis" group, as a whole. Grafts with less than 30% predominant macro-, or microsteatosis also had poorer outcomes with lower patient and graft survival rates. CONCLUSION: Steatotic liver grafts were used on a large scale (71%) in this clinical series. The analysis confirms that using grafts with moderate (>30%) and severe steatosis (>60%) have a negative impact on outcomes. The authors conclude that using these grafts allow a significant increase in organ offer that counterbalances the negative outcome for patients who are not offered a transplant, and this supports the need for further clinical research.
BACKGROUND: Clinical demand for liver transplant steadily grows while organs offer has reached a plateau years ago. To expand the donor liver pool, various options have been considered including acceptance of suboptimal donors and steatotic grafts, with a risk of poorer outcomes. The latter risk and its relation to the grade of liver graft steatosis have been studied in this prospective clinical study. METHODS: One hundred eighteen consecutive liver transplantation (115 patients) performed between May 2002 and March 2008 were prospectively analyzed. According to the grade of steatosis on a 2 hr postreperfusion biopsy, four groups were considered: absence (<5%) (n=34), mild (<30%) (n=40), moderate (30%-60%) (n=23), or severe steatosis (> or = 60%) (n=21). Donors and recipients demographic data, and patients and grafts survival rates were compared among the four groups. RESULTS: Eighty-four (71%) grafts presented some degree of steatosis (macrosteatosis: 19.5%, microsteatosis: 47%, mix type: 33.5%). Patient and graft survival were significant lower in the "severe steatosis" group, as a whole. Grafts with less than 30% predominant macro-, or microsteatosis also had poorer outcomes with lower patient and graft survival rates. CONCLUSION: Steatotic liver grafts were used on a large scale (71%) in this clinical series. The analysis confirms that using grafts with moderate (>30%) and severe steatosis (>60%) have a negative impact on outcomes. The authors conclude that using these grafts allow a significant increase in organ offer that counterbalances the negative outcome for patients who are not offered a transplant, and this supports the need for further clinical research.
Authors: Kyle R Jackson; Jennifer D Motter; Christine E Haugen; Jane J Long; Betsy King; Benjamin Philosophe; Allan B Massie; Andrew M Cameron; Jacqueline Garonzik-Wang; Dorry L Segev Journal: Transplantation Date: 2019-11-20 Impact factor: 4.939
Authors: Kim H H Liss; Kyle S McCommis; Kari T Chambers; Terri A Pietka; George G Schweitzer; Sara L Park; Ilke Nalbantoglu; Carla J Weinheimer; Angela M Hall; Brian N Finck Journal: Liver Transpl Date: 2018-07 Impact factor: 5.799
Authors: Ricardo C Gehrau; Valeria R Mas; Catherine I Dumur; Jihee L Suh; Ashish K Sharma; Helen P Cathro; Daniel G Maluf Journal: Transplantation Date: 2015-12 Impact factor: 4.939
Authors: Natalie M Bath; Glen Leverson; David P Al-Adra; Anthony M D'Alessandro; Joshua D Mezrich; David P Foley Journal: Liver Transpl Date: 2020-09 Impact factor: 5.799
Authors: Kyle R Jackson; Jennifer D Motter; Christine E Haugen; Jane J Long; Betsy King; Benjamin Philosophe; Allan B Massie; Andrew M Cameron; Jacqueline Garonzik-Wang; Dorry L Segev Journal: Transplantation Date: 2020-08 Impact factor: 5.385