Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study
Journal Title: Annals of Hepatology - Year 2012, Vol 11, Issue 6
Abstract
Introduction. 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 ourtransplant program. Material and methods. 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%. Results. 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). Conclusion. Macrovesicular steatosis was associated with a poor outcome in this series. A protocol bench-biopsy would be useful to identify these grafts.
Authors and Affiliations
Mauricio Gabrielli, Fabrizio Moisan, Marcela Vidal, Ignacio Duarte, Macarena Jiménez, Guillermo Izquierdo, Pilar Domínguez, Javier Méndez, Alejandro Soza, Carlos Benitez, Rosa Pérez, Marco Arrese, Juan Guerra, Nicolás Jarufe, Jorge Martínez
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