BACKGROUND: Livers with moderate (30-60%) macrovesicular steatosis have been associated with poor outcome after transplantation. Aim of this study was to examine the outcome after transplantation of livers with moderate macrovesicular steatosis when the cold ischemia time (CIT) is kept very short. METHODS: Postoperative outcome of 19 recipients of a moderate steatotic liver were compared with a matched control group of 95 recipients of a nonsteatotic liver graft (1:5 ratio). We studied graft/patient survival rates, incidences of primary nonfunction, postoperative complications (classified according to the Clavien-Dindo classification), first-week postoperative hepatic injury serum markers (AST/ALT), and liver function tests (PT time/bilirubin/lactate). In addition, we studied reversal of graft steatosis in follow-up biopsies. RESULTS: Median CIT in livers with moderate steatosis and in controls was below 8 h in both groups. Although short- and long-term patient/graft survival rates and results of liver function tests were similar, serum markers of hepatic injury and postoperative complications (especially grade IVa) were significantly higher in recipients of a moderate steatotic liver. Reversal of steatosis was seen in 9 of the 11 (82%) recipients with follow-up liver biopsies. CONCLUSION: Despite the association with severe postoperative complications, moderate macrovesicular steatotic livers can be used successfully for transplantation if the CIT is kept very short.
BACKGROUND: Livers with moderate (30-60%) macrovesicular steatosis have been associated with poor outcome after transplantation. Aim of this study was to examine the outcome after transplantation of livers with moderate macrovesicular steatosis when the cold ischemia time (CIT) is kept very short. METHODS: Postoperative outcome of 19 recipients of a moderate steatotic liver were compared with a matched control group of 95 recipients of a nonsteatotic liver graft (1:5 ratio). We studied graft/patient survival rates, incidences of primary nonfunction, postoperative complications (classified according to the Clavien-Dindo classification), first-week postoperative hepatic injury serum markers (AST/ALT), and liver function tests (PT time/bilirubin/lactate). In addition, we studied reversal of graft steatosis in follow-up biopsies. RESULTS: Median CIT in livers with moderate steatosis and in controls was below 8 h in both groups. Although short- and long-term patient/graft survival rates and results of liver function tests were similar, serum markers of hepatic injury and postoperative complications (especially grade IVa) were significantly higher in recipients of a moderate steatotic liver. Reversal of steatosis was seen in 9 of the 11 (82%) recipients with follow-up liver biopsies. CONCLUSION: Despite the association with severe postoperative complications, moderate macrovesicular steatotic livers can be used successfully for transplantation if the CIT is kept very short.
Authors: Andrew D Posner; Samuel T Sultan; Norann A Zaghloul; William S Twaddell; David A Bruno; Steven I Hanish; William R Hutson; Laci Hebert; Rolf N Barth; John C LaMattina Journal: Clin Transplant Date: 2017-07-13 Impact factor: 2.863
Authors: Jurgis Alvikas; Andrew-Paul Deeb; Dana R Jorgensen; Marta I Minervini; Anthony J Demetris; Kristina Lemon; Xilin Chen; Hanna Labiner; Shahid Malik; Christopher Hughes; Abhinav Humar; Amit Tevar Journal: Transplant Proc Date: 2021-04-27 Impact factor: 1.014
Authors: Irene Beijert; Safak Mert; Viola Huang; Negin Karimian; Sharon Geerts; Ehab O A Hafiz; James F Markmann; Heidi Yeh; Robert J Porte; Korkut Uygun Journal: Transplant Direct Date: 2018-04-23
Authors: Simon Moosburner; Joseph M G V Gassner; Maximilian Nösser; Julian Pohl; David Wyrwal; Felix Claussen; Paul V Ritschl; Duska Dragun; Johann Pratschke; Igor M Sauer; Nathanael Raschzok Journal: HPB Surg Date: 2018-11-01
Authors: Zoltan Czigany; Wenzel Schöning; Tom Florian Ulmer; Jan Bednarsch; Iakovos Amygdalos; Thorsten Cramer; Xavier Rogiers; Irinel Popescu; Florin Botea; Jiří Froněk; Daniela Kroy; Alexander Koch; Frank Tacke; Christian Trautwein; Rene H Tolba; Marc Hein; Ger H Koek; Cornelis H C Dejong; Ulf Peter Neumann; Georg Lurje Journal: BMJ Open Date: 2017-10-10 Impact factor: 2.692