Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study

• Published in: Annals of hepatology 2012-11, Vol.11 (6), p.891-898
• Main Authors: Gabrielli, Mauricio, Moisan, Fabrizio, Vidal, Marcela, Duarte, Ignacio, Jiménez, Macarena, Izquierdo, Guillermo, Domínguez, Pilar, Méndez, Javier, Soza, Alejandro, Benitez, Carlos, Pérez, Rosa, Arrese, Marco, Guerra, Juan, Jarufe, Nicolás, Martínez, Jorge
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Biopsy; Body Mass Index; Chi-Square Distribution; Chile - epidemiology; Donor Selection; Fatty liver; Fatty Liver - epidemiology; Fatty Liver - pathology; Fatty Liver - surgery; Female; Graft Survival; Hepatectomy; Humans; Kaplan-Meier Estimate; Liver steatosis; Liver transplantation; Liver Transplantation - adverse effects; Liver Transplantation - mortality; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Organ injury; Postoperative Complications - epidemiology; Predictive Value of Tests; Prevalence; Prospective Studies; Risk Factors; Severity of Illness Index; Time Factors; Tissue Donors - supply & distribution; Transplantation; Treatment Outcome; Young Adult
• ISSN: 1665-2681
• DOI: 10.1016/S1665-2681(19)31415-2

Steatotic livers have been associated with greater risk of allograft dysfunction in liver transplantation. Our aim was to determinate the prevalence of steatosis in grafts from deceased donors in Chile and to assess the utility of a protocol-bench biopsy as an outcome predictor of steatotic grafts in our transplant program. We prospectively performed protocol-bench graft biopsies from March 2004 to January 2009. Biopsies were analyzed and classified by two independent pathologists. Steatosis severity was graded as normal from absent to < 6%; grade 1: 6-33%; grade 2: > 33-66% and grade 3: > 66%. We analyzed 58 liver grafts from deceased donors. Twenty-nine grafts (50%) were steatotic; 9 of them (16%) with grade 3. Donor age (p < 0.001) and BMI over 25 kg/m 2 (p = 0.012) were significantly associated with the presence of steatosis. There were two primary non-functions (PNF); both in a grade 3 steatotic graft. The 3-year overall survival was lower among recipients with macrovesicular steatotic graft (57%) than recipients with microvesicular (85%) or non-steatotic grafts (95%) (p = 0.026). Macrovesicular steatosis was associated with a poor outcome in this series. A protocol bench-biopsy would be useful to identify these grafts.