High-grade microsteatosis and delay in hepatic function after orthotopic liver transplantation

Does Donor Allograft Microsteatosis Matter? Comparison of Outcomes in Liver Transplantation With a Propensity‐Matched Cohort

“…In the present study, the causes for donor microsteatosis were largely unknown; therefore, no distinction could be made on the basis of etiology. Previous authors have suggested a distinction between 2 subgroups of microsteatosis: high grade and low grade . Low‐grade microsteatosis was defined as several small vesicles that did not result in cell enlargement, whereas high‐grade microsteatosis presented with many small vesicles that did result in cell enlargement.…”

“…Previous authors have suggested a distinction between 2 subgroups of microsteatosis: high grade and low grade. (28) Low-grade microsteatosis was defined as several small vesicles that did not result in cell enlargement, whereas high-grade microsteatosis presented with many small vesicles that did result in cell enlargement. In their study, they demonstrated that high-grade microsteatosis was more likely to be associated with DGF and that amount of microsteatosis was of less importance.…”

Histopathological Syndromes of Liver Allograft Rejection and Recurrent Disease

“…Necrosis in donor biopsies has negatively impacted recipient outcome in some [11,12], but not all studies [8,13]. In our experience, the liver is usually disqualified if >10% (roughly estimated) of hepatocytes are necrotic and the necrosis diffusely involves both the wedge and needle cores; the assessment should not be based on isolated subcapsular necrosis and should be correlated with donor liver injury test profiles.…”

“…Microvesicular steatosisis often occurs after a short period of warm ischemia and usually does not adversely affect outcome. However, one study associated "high grade" microvesicular steatosis with delayed graft function [8]. In our opinion, the severity of macrovesicular steatosis can be roughly estimated on hematoxylin and eosin (H&E) stained slides alone.…”

Steatotic donor livers: Where is the risk‐benefit maximized?

“…An earlier study published in 1991 by Ploeg et al, reported an 80% (4/5) PNF rate . A subsequent series found a 0%‐66% PNF rate and a 17%‐80% IPF rate . A case‐control study conducted by McCormack et al, in which severely steatotic (n = 20) versus nonsteatotic (n = 40) transplants were matched for wait‐list status, Model of End‐Stage Liver Disease (MELD) score, and recipient BMI, reported significantly higher IPF (30% versus 10%) but a comparable 3‐year patient survival (84% versus 83%) .…”