Hepatic steatosis and its relationship to transplantation

Imber, Charles; Peter, Shawn D. St.; Handa, Ashok; Friend, Peter J.

doi:10.1053/jlts.2002.32275

Cited by 150 publications

(125 citation statements)

References 63 publications

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“…Preliminary data suggest that overall patient and graft survival rates have been acceptable using such carefully selected marginal donors as those older than 50 years and donor livers with less than 30% steatosis on biopsy. 11,12 Conversely, results with non-heart-beating donors and severely steatotic livers have been less favorable. 13,14 Hepatitis B core antibody-positive (HBcAb ϩ ) cadaveric donor livers also are considered marginal because of the 25% to 90% risk for hepatitis B virus (HBV) transmission to the recipient.…”

mentioning

confidence: 99%

Are we ready for marginal hepatitis B core antibody-positive living liver donors?

Fontana¹

2003

Liver Transplantation

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mentioning

confidence: 99%

Are we ready for marginal hepatitis B core antibody-positive living liver donors?

Fontana¹

2003

Liver Transplantation

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“…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%

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.

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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.

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“…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%

“…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] . Most transplant centers do not use grafts with more than 30% of macrovescicular steatosis.…”

Section: Steatosismentioning

confidence: 99%

Strategies to optimize the use of marginal donors in liver transplantation

Pezzati

Ghinolfi

Simone

et al. 2015

WJH

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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.

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Hepatic steatosis and its relationship to transplantation

Cited by 150 publications

References 63 publications

Are we ready for marginal hepatitis B core antibody-positive living liver donors?

Are we ready for marginal hepatitis B core antibody-positive living liver donors?

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

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