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
Keywords
Related Articles
- EP ID EP78210
- DOI -
- Views 114
- Downloads 0
Hepatolithiasis with secondary cholangitis and supernumerary left hepatic lobe
We report the case of a 31-year old woman with recurrent cholangitis secondary to hepatolithiasis. The stones were composed of calcium bilirrubinate. The patient also had a supernumerary hepatic lobe connected to the inf...
Schistosomal portal hypertension: Randomized trial comparing endoscopic therapy alone or preceded by esophagogastric devascularization and splenectomy
Background. Upper gastrointestinal bleeding is a major cause of morbidity and mortality in patients with portal hypertension secondary to schistosomiasis mansoni. Aim. To evaluate the efficacy of combined surgery and sc...
Serum cystatin C measurement in differential diagnosis of intra and extrahepatic cholestatic diseases
Objective. Cystatin C is a very potent inhibitor of cysteine proteinases and, it has been clinically applied as a sensitive marker in monitoring of renal and liver functions. The aim of this study was to reveal whether...
The impact of diabetes mellitus in mortality of patients with compensated liver cirrhosis-a prospective study
Background. It has been suggested that DM may reduce survival of patients with liver cirrhosis (LC). Nevertheless only few prospective studies assessing the impact of DM on mortality of cirrhotic patients have been publi...
Rhabdomyolysis in a hepatitis C virus infected patient treated with telaprevir and simvastatin
A 46-year old man with a chronic hepatitis C virus infection received triple therapy with ribavirin, pegylated interferon and telaprevir. The patient also received simvastatin. One month after starting the antiviral ther...