Hepatic Steatosis in Organ Donors: Disparity Between Surgery and Histology?

The Liver Biopsy During Organ Procurement

“…As far as differences between the liver lobes are concerned, we have learned from our study of explanted livers that in all but one case (out of 50) the degree of fibrosis or steatosis did not significantly vary among the different liver segments or the liver lobes (Rey et al, 2009). However, our single case with focal biliary cirrhosis in the right, but nor the left liver lobe, (Fig.…”

“…Histopathological examination should provide a helpful decision for the transplant surgeon whether or not the organ is suitable for transplantation. Therefore, in all cases of organ procurement a wedge biopsy of 1-cm side length should be performed in two liver segments, one for each liver lobe (i.e., segments 3 and 6 or 7) (Frankel et al, 2002;Rey et al, 2009). To evaluate liver quality is one of the most difficult surgical challenges during organ procurement.…”

“…Congenital autosomal dominant or recessive cystic disease can be found in some cases; here the identification of renal and pancreatic cysts is important. Depending on the degree of cyst formation, even those organs may be considered transplantable (Rey et al, 2009). In children, a cystic mesenchymal hamartoma of childhood should be considered, whenever a pediatric liver transplant is in question.…”

Appraisal of donor steatosis in liver transplantation: a survey of current practice in Australia and New Zealand

“…Of concern, 16.7% of the livers discarded on the basis of visual and palpation appraisal as being nontransplantable were within the acceptable histological criteria for transplantation. 27 In another single-center experience, institution of protocol biopsies of all donor livers resulted in a reduction of PNF rates from 8.4% to 1.4%, due to better selection and rejection of organs that fell in the moderate-steatosis category. 28 Histological appraisal of the donor organ, while more objective, is not always straightforward, owing to regional variation in steatosis and differences in staining techniques.…”

Aspectos histopatológicos de la evaluación del donante en trasplante hepático, una aproximación a la consulta intraoperatoria

“…El conocimiento de la duda que generó el estudio debe ser informado al pató-logo, ya que facilita el estudio e interpretación de los hallazgos, en especial el conocimiento de la inspección visual y palpación del hígado durante el procedimiento quirúrgico, aun cuando es bien conocido que es un dato subjetivo y depende de la experiencia del cirujano (4,5).…”