Influence of Degree of Hepatic Steatosis on Graft Function and Postoperative Complications of Liver Transplantation

Daga, J.A. Pérez; Santoyo-Santoyo, Julio; Suárez, Miguel Ángel; Fernández-Aguilar, J.A.; Ramirez, Carlo B.; Rodríguez‐Cañete, Alberto; Aranda, José Manuel Ramírez; Sánchez-Pérez, Belinda; Montiel, Custodia; Palomo, D. García; Ruíz, Manuela Expósito; Mate, A.

doi:10.1016/j.transproceed.2006.08.077

Cited by 68 publications

(52 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Microvescicular steatosis is defined as accumulation of small fatty droplets not displacing the cell nucleus, but it does not determine a higher risk for graft loss after LT (25). On the opposite, macrovescicular steatosis, which is characterized by large droplets displacing the nucleus to the cell periphery, is related to a higher risk for graft failure and PNF (25,26). Macrosteatosis is classified based on the proportion of hepatocytes affected in mild (<30%), moderate (from 30% to 60%), and severe (>60%) (25)(26)(27).…”

Section: Steatosismentioning

confidence: 99%

“…On the opposite, macrovescicular steatosis, which is characterized by large droplets displacing the nucleus to the cell periphery, is related to a higher risk for graft failure and PNF (25,26). Macrosteatosis is classified based on the proportion of hepatocytes affected in mild (<30%), moderate (from 30% to 60%), and severe (>60%) (25)(26)(27). Under this circumstance, the liver might be more subjected to lipid peroxidation (28), a more accentuated proinflammatory response with release of mediators, such as tumor necrosis factor (TNF)-α, and an increased neutrophil infiltration (29) thus heightening the sensitivity to I/R injury and increasing the risk of DGF and PNF.…”

Section: Steatosismentioning

confidence: 99%

“…Under this circumstance, the liver might be more subjected to lipid peroxidation (28), a more accentuated proinflammatory response with release of mediators, such as tumor necrosis factor (TNF)-α, and an increased neutrophil infiltration (29) thus heightening the sensitivity to I/R injury and increasing the risk of DGF and PNF. As a consequence, moderate macrosteatosis is still a relative contraindication to LT (25), while severe is mainly considered an absolute contraindication.…”

Section: Steatosismentioning

confidence: 99%

See 2 more Smart Citations

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Ghinolfi

Rreka

Pezzati

et al. 2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancers, is the second leading cause of cancer-related deaths and the leading cause of death in patients with cirrhosis. Liver transplantation (LT) represents the ideal treatment for selected patients as it removes both the tumor and the underlying cirrhotic liver with 5-year survival rates higher than 70%. Unfortunately, due to tumor characteristics, patient co-morbidities or shortage of organs available for transplant, only 20% of patients can undergo curative treatment. Ex situ machine perfusion (MP) is a technology recently introduced that might potentially improve organ preservation, allow graft assessment and increase the pool of available organs. The purpose of this review is to provide an update on the current role of ex situ liver MP in liver transplantation for HCC patients.

show abstract

Section: Steatosismentioning

confidence: 99%

Section: Steatosismentioning

confidence: 99%

Section: Steatosismentioning

confidence: 99%

See 1 more Smart Citation

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Ghinolfi

Rreka

Pezzati

et al. 2017

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

show abstract

“…Microvescicular steatosis is accumulation of small fatty droplets not displacing the cell nucleus, and even if diffuse it does not entail a higher risk for graft loss after LT [42] . Macrovescicular steatosis is characterized by large droplets displacing the nucleus to the cell periphery and is associated with a significant risk factor for PNF [42,43] . It can be classified based on the proportion of hepatocytes affected, being mild < 30%, moderate from 30% to 60%, and severe > 60% [43] .…”

Section: Steatosismentioning

confidence: 99%

Strategies to optimize the use of marginal donors in liver transplantation

Pezzati

Ghinolfi

Simone

et al. 2015

WJH

View full text Add to dashboard Cite

Liver transplantation is the treatment of choice for end stage liver disease, but availability of liver grafts is still the main limitation to its wider use. Extended criteria donors (ECD) are considered not ideal for several reasons but their use has dramatically grown in the last decades in order to augment the donor liver pool. Due to improvement in surgical and medical strategies, results using grafts from these donors have become acceptable in terms of survival and complications; nevertheless a big debate still exists regarding their selection, discharge criteria and allocation policies. Many studies analyzed the use of these grafts from many points of view producing different or contradictory results so that accepted guidelines do not exist and the use of these grafts is still related to non-standardized policies changing from center to center. The aim of this review is to analyze every step of the donationtransplantation process emphasizing all those strategies, both clinical and experimental, that can optimize results using ECD.

show abstract

“…Steatosis of the liver is classified into three grades according to the proportion of hepatocytes with fatty infiltration: mild (< 30%), moderate (30-60%), and severe (> 60%) (Adam et al 1991). It has been shown that the degree of steatosis correlates with higher post-operative liver enzymes and increased long-term mortality of liver transplantation (Perez-Daga et al 2006). However, no reports have evaluated IR injury at different degrees of steatosis in the same experimental models.…”

Section: Introductionmentioning

confidence: 99%

Interaction of Kupffer Cells and Platelets Determines the Severity of Ischemia-Reperfusion Injury in Steatosis

Ogawa

Kondo

Tamura

et al. 2014

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

Liver steatosis increases the risk of postoperative complications following major liver resection, since the steatotic liver is susceptible to ischemia-reperfusion (IR) injury. However, it is unclear how IR injury changes in relation to the degree of hepatic steatosis. Previously, we reported that interaction between Kupffer cells (KCs) and platelets induced hepatic IR injury. The aim of our present study was to evaluate the relationship between the degree of liver steatosis and IR injury by focusing on the interaction of KCs and platelets. Mild and moderate steatotic liver models were generated in Wistar rats by feeding a cholinedeficient diet for 2 and 4 weeks, respectively. The intensity of steatosis was defined based on the proportion of hepatocytes with fatty infiltration: normal (less than 5%), a mild steatosis (5-30%), and moderate steatosis (30-60%). All groups were subjected to 20 min of warm ischemia followed by 120 min of reperfusion. The number of adhesion of KCs to platelets in sinusoids was observed by intravital microscopy. IR injury was evaluated with serum alanine aminotransferase levels, histological findings, and sinusoidal perfusion. Compared to the normal liver, mild steatosis reduced the adhesion of KCs to platelets, inducing the attenuation of IR injury. In contrast, moderate steatosis increased the adhesion of KCs to platelets, aggravating IR injury relative to the normal liver. IR injury in the steatotic liver was not simply proportional to the degree of steatosis. Mild steatosis ameliorates IR injury compared to the normal liver, whereas moderate steatosis increases IR injury.

show abstract

Influence of Degree of Hepatic Steatosis on Graft Function and Postoperative Complications of Liver Transplantation

Cited by 68 publications

References 7 publications

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Strategies to optimize the use of marginal donors in liver transplantation

Interaction of Kupffer Cells and Platelets Determines the Severity of Ischemia-Reperfusion Injury in Steatosis

Contact Info

Product

Resources

About