Assignment of steatotic livers by the Mayo model for end-stage liver disease.
Prognosis after liver transplantation depends on a combination of recipient and donor variables. The purpose of this study is to define an allocation system of steatotic donor livers relative to recipient model for end-stage liver disease (MELD) score. We reviewed 500 consecutive OLT, computing the MELD score for each recipient. Fatty infiltration in grafts was categorized in no steatosis, 10-30%, 30-60% and > or = 60% steatosis. MELD score did not affect preservation injury and graft dysfunction, which were increased with fat content. Recipient and graft survivals lowered when increasing MELD score. Outcome in low-risk recipients (MELD < or = 9) was not altered with steatosis, except those with > or = 60%. Survival functions in moderate-risk recipients (MELD 10-19) were moderately affected with 10-30% steatosis and severely with those with >30. Exactly 30-60% steatotic grafts work poorly in high-risk recipients (MELD > or = 20), and very poorly with > or = 60% steatosis. Prognosis of candidates is optimally influenced when divergence of recipient-donor risks is presented.
Briceño
Javier
J
Unit of Liver Transplantation, Department of Surgery, Hospital Reina Sofía, Córdoba, Spain. javibriceno@hotmail.com
Padillo
Javier
J
Rufián
Sebastián
S
Solórzano
Guillermo
G
Pera
Carlos
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D046148:Donor Selection; D005234:Fatty Liver / Q000473:pathology*; D005260:Female; D006085:Graft Survival; D006801:Humans; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D014019:Tissue Donors; D009927:Tissue and Organ Procurement