The team evaluated the influence of steatosis, and of other donor and recipient characteristics, in affecting liver performance after orthotopic liver transplantation (OLT).
311 consecutive liver transplantations conducted in 278 patients were included in the study.
The donor variables considered were age, sex, blood group, cause of death, intensive care unit days, need for vasopressors, hepatic enzymes and bilirubin, total and warm ischemia time, and macro- and microvescicular steatosis.
|Macrovescicular steatosis is associated with graft failure.|
|Clinical Transplantation |
Recipient variables considered were age, sex, blood group, biliary output, and post-OLT peak levels of hepatic enzymes.
The only variable found to be independently associated with shorter patient survival was macrovescicular steatosis involving 25% or more of the hepatocytes.
Of eight livers identified with this condition, delayed non-function occurred in five (62.5%) and primary non-function occurred in one (12.5%).
In the group with macrovescicular steatosis involving less than 25% of the liver cells, the incidence of delayed non-function and primary non-function was 1.6% and 2.3%, respectively.
The team found that microvescicular steatosis of any degree was not associated with a worse prognosis.
Fausto Zamboni, of the Molinette Hospital and University, Turin, concluded on behalf of the group, "Macrovescicular steatosis involving 25% or more of the hepatocytes identifies marginal livers, the use of which significantly increases the risk of graft non-function post-orthotopic liver transplantation."