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

• Main Authors: 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, M.D.
• Format: Article
• Language: English
• Published: Elsevier 2012-11-01
• Series: Annals of Hepatology
• Subjects: Fatty liver; Liver steatosis; Liver transplantation; Organ injury; Transplantation
• Online Access: http://www.sciencedirect.com/science/article/pii/S1665268119314152
• ISSN: 1665-2681

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 our transplant 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/m2 (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. Macro-vesicular steatosis was associated with a poor outcome in this series. A protocol bench-biopsy would be useful to identify these grafts.