Liver transplantation using fatty livers: Always feasible?
McCormack L, Dutkowski P, El-Badry AM, Clavien PA. J Hepatol. 2011 May;54(5):1055-62. (CUMC Full Text PDF).
The authors review the available data about utilizing steatotic grafts in liver transplantation. As the authors point out, different methods of assessing steatosis (gross assessment, frozen H&E section, permanent H&E sections, oil-red-O, sudan black, digital analysis, chemical quantitation methods in tissue etc), evaluation of macro vs micro steatosis, and pathologists's interobserver variability are among the various problems that may contribute to the widely variable outcomes seen in different studies according to the degree of steatosis. In general, a mild degree of macrovesicular steatosis (<30%) is associated with relatively low rates of complications (prolonged ICU time, primary graft non function etc.) while severe macrovesicular steatosis (>60%) is associated with increased rates of complications. The risk associated with moderate steatosis (30-60%), however, is highly variable and the risk conferred by microvesicular steatosis is not well-established.
McCormack L, Dutkowski P, El-Badry AM, Clavien PA. J Hepatol. 2011 May;54(5):1055-62. (CUMC Full Text PDF).
The authors review the available data about utilizing steatotic grafts in liver transplantation. As the authors point out, different methods of assessing steatosis (gross assessment, frozen H&E section, permanent H&E sections, oil-red-O, sudan black, digital analysis, chemical quantitation methods in tissue etc), evaluation of macro vs micro steatosis, and pathologists's interobserver variability are among the various problems that may contribute to the widely variable outcomes seen in different studies according to the degree of steatosis. In general, a mild degree of macrovesicular steatosis (<30%) is associated with relatively low rates of complications (prolonged ICU time, primary graft non function etc.) while severe macrovesicular steatosis (>60%) is associated with increased rates of complications. The risk associated with moderate steatosis (30-60%), however, is highly variable and the risk conferred by microvesicular steatosis is not well-established.
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