Steatosis of the donor liver impacts on both patient and allograft outcome after orthotopic liver transplantation (OLT).
In this study, researchers from Sydney, Australia, evaluated the effect of increasing grades of cadaveric donor liver steatosis on recipient outcome.
The team assessed 120 OLTs performed using 72 mild, 25 moderate, and 23 severely steatotic donor livers, between 1986 and 2000.
| Initial poor graft function was more common in donor livers with either moderate or severe steatosis.|
The team established that donors of steatotic livers were more likely to be older, and to have died of intracerebral hemorrhage than donors of nonsteatotic livers.
They found that initial poor graft function (IPF) was more common in donor livers with either moderate or severe steatosis, than in livers with mild steatosis.
Primary graft nonfunction (PNF) only occurred in 1 donor liver with severe steatosis.
In addition, prostaglandin E1 (PGE1) usage was higher in recipients of donor livers with moderate or severe steatosis, compared with donor livers with mild steatosis.
Furthermore, allograft loss was greater at 1 year both in the moderate and severe steatotic liver groups.
The researchers determined that patient survival at 3 months and overall allograft survival both were impacted negatively by increasing grades of donor liver steatosis.
They also found that 3-month allograft survival was reduced in the steatotic donor livers if the donor was over 50 years old.
The team identified that recipient status at OLT, and donor steatosis impacted on 30 day allograft survival.
Dr Deborah Verran’s team concluded, “Increasing grades of donor liver steatosis were associated with worse IPF and increased PGE1 usage”.
“There was a negative impact of steatosis on both recipient and early allograft survival”.