Reversal of Graft Steatosis After Liver Transplantation: Prospective Study

Li, J.; Liu, B.; Yan, Lü-Nan; Zuo, Yunxia; Li, B.; Zeng, Yong; Zhang, S.F.; Li, F.-G.

doi:10.1016/j.transproceed.2009.06.222

Cited by 38 publications

(28 citation statements)

References 12 publications

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“…It is reasonable to project that steatosis would have been shown to fully resolve on subsequent biopsies from those two recipients, had later biopsies been available. Histological changes in our study demonstrating the resolution of steatosis were similar to those presented by Marsman et al, Li et al, and McCormack et al 15,21,22 In addition to the initial resolution, we also observed that there was no evidence of recurrent steatosis in the longer term biopsies, which may relate to the fact that none of the recipients in the study group originally had NASH.…”

Section: | Discussionsupporting

confidence: 91%

Resolution of donor non‐alcoholic fatty liver disease following liver transplantation

Posner

Sultan

Zaghloul

et al. 2017

Clinical Transplantation

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Introduction Transplant surgeons conventionally select against livers displaying high degrees (>30%) of macrosteatosis (MaS), out of concern for primary non-function or severe graft dysfunction. As such, there is relatively limited experience with such livers, and the natural history remains incompletely characterized. We present our experience of transplanted livers with high degrees of MaS and microsteatosis (MiS), with a focus on the histopathologic and clinical outcomes. Methods Twenty-nine cases were identified with liver biopsies available from both the donor and the corresponding liver transplant recipient. Donor liver biopsies displayed either MaS or MiS ≥15%, while all recipients received postoperative liver biopsies for cause. Results The mean donor MaS and MiS were 15.6% (range 0%–60%) and 41.3% (7.5%–97.5%), respectively. MaS decreased significantly from donor (M=15.6%) to recipient postoperative biopsies (M=0.86%), P<.001. Similarly, MiS decreased significantly from donor biopsies (M=41.3%) to recipient postoperative biopsies (M=1.8%), P<.001. At a median of 68 days postoperatively (range 4–384), full resolution of MaS and MiS was observed in 27 of 29 recipients. Conclusions High degrees of MaS and MiS in donor livers resolve in recipients following liver transplantation. Further insight into the mechanisms responsible for treating fatty liver diseases could translate into therapeutic targets.

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Section: | Discussionsupporting

confidence: 91%

Resolution of donor non‐alcoholic fatty liver disease following liver transplantation

Posner

Sultan

Zaghloul

et al. 2017

Clinical Transplantation

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“…The mechanism of this phenomenon remains elusive, but may have important consequences for the long-term outcome. Independent factors that negatively affect this reversal of steatosis were donor age (>50 years) and prolonged cold ischemia time (>12 h) [32]. Corresponding to the fat changes in transplanted liver grafts, the presence of moderate to severe MaS before LT did not affect long-term organ survival [5].…”

Section: Impact Of Graft Steatosis On Long-term Outcome After Ltmentioning

confidence: 99%

“…Accumulating evidence from clinical and experimental observations indicates that steatosis in liver grafts increases complications after LT [19,32] [19,31] such as prolonged ICU stay, hospital stay, the incidence of primary graft dysfunction or non-function, and cost [30,50,60]. However, while there is general agreement that mild steatosis (<30%) causes minor graft injury, studies have been inconsistent regarding the relevance of the higher degree of steatosis (>30%) or type of fat [1,12,24,[33][34][35][36].…”

Section: Impact On Early Post-transplant Outcomementioning

confidence: 99%

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Liver transplantation using fatty livers: Always feasible?

McCormack

Dutkowski²,

El‐Badry³

et al. 2011

Journal of Hepatology

256

236

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Steatotic liver grafts represent the most common type of "extended criteria" organs that have been introduced during the last two decades due to the disparity between liver transplant candidates and the number available organs. A precise definition and reliable and reproducible method for steatosis quantification is currently lacking and the potential influence of the chemical composition of hepatic lipids has not been addressed. In our view, these shortcomings appear to contribute significantly to the inconsistent results of studies reporting on graft steatosis and the outcome of liver transplantation. In this review, various definitions, prevalence and methods of quantification of liver steatosis will be covered. Ischemia/reperfusion injury of the steatotic liver and its consequences on post-transplant outcome will be discussed. Selection criteria for organ allocation and a number of emerging protective strategies are suggested.

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“…Despite the poorer early posttransplant results, moderate steatosis seems not to significantly impact the longterm outcome once the recipient has passed the higher‐risk perioperative phase. This might be linked to the ability of grafts to decrease fatty infiltrations after liver transplantation . Another large multivariate study combined the European Liver Transplant Registry and UNOS databases and evaluated transplant outcomes by using an adjusted balance of risk (BAR) score with focusing on the presence of graft steatosis.…”

Section: Clinical Outcome In Liver Transplantation Using Fatty Liversmentioning

confidence: 99%