Impact of steatotic grafts on initial function and prognosis after liver transplantation

Abstract

Steatotic grafts are considered a risk factor for dysfunction or even primary nonfunction of liver transplants; grafts with more than 50% fatty infiltration are routinely discarded. This retrospective study evaluated the impact of macrovesicular and microvesicular steatosis on postoperative initial liver function and prognosis by comparing outcomes to nonsteatotic grafts in 48 liver transplantation patients. Fifteen grafts had macrovesicular steatosis, 13 (27.09%) up to 50% fatty infiltration (MG2), and 2 (4.16%) more than 50% (MG3). Thirty-three (69.75%) grafts had no macrovesicular steatosis (MG1). Initial liver function was adequate in 26 (78.78%), 10 (76.93), and 2 (100%) patients, respectively, in subgroups MG1, MG2, and MG3 ( P = .892). Thirty-day survival rates were 90.90%, 100%, and 100%, respectively, in subgroups MG1, MG2, and MG3 ( P = .606). Twenty-six grafts showed microvesicular steatosis: 18 (37.50%) showed less than 50% fatty infiltration (mG2), and 8 (16.67%) more than 50% (mG3). Twenty-two (45.83%) grafts had no microvesicular steatosis (mG1). Initial liver function was adequate in 16 (72.72%), 16 (88.88%), and 6 (75%) patients, respectively, in subgroups mG1, mG2, and mG3 ( P = .547). Thirty-day survival rates were 90.90%, 100%, and 87.5% respectively, in subgroups mG1, mG2, and mG3 ( P = .380). In conclusion, macrovesicular and microvesicular steatotic liver grafts displayed adequate initial function, did not compromise survival, and thus should not be routinely discarded.