title: Steatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study.
abstract: BACKGROUND
  Steatotic livers have been associated with greater risk of allograft dysfunction in liver transplantation. Our aim was to determinate the prevalence of steatosis in grafts from deceased donors in Chile and to assess the utility of a protocol-bench biopsy as an outcome predictor of steatotic grafts in our transplant program.
  
  
  METHODS
  We prospectively performed protocol-bench graft biopsies from March 2004 to January 2009. Biopsies were analyzed and classified by two independent pathologists. Steatosis severity was graded as normal from absent to < 6%; grade 1: 6-33%; grade 2: > 33-66% and grade 3: > 66%.
  
  
  RESULTS
  We analyzed 58 liver grafts from deceased donors. Twenty-nine grafts (50%) were steatotic; 9 of them (16%) with grade 3. Donor age (p < 0.001) and BMI over 25 kg/m 2 (p = 0.012) were significantly associated with the presence of steatosis. There were two primary non-functions (PNF); both in a grade 3 steatotic graft. The 3-year overall survival was lower among recipients with macrovesicular steatotic graft (57%) than recipients with microvesicular (85%) or non-steatotic grafts (95%) (p = 0.026).
  
  
  CONCLUSIONS
  Macrovesicular steatosis was associated with a poor outcome in this series. A protocol bench-biopsy would be useful to identify these grafts.
authors.affiliation: Liver Unit, Department of Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Gabrielli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Moisan
authors.forename: Marcela
authors.initials: M
authors.lastname: Vidal
authors.forename: Ignacio
authors.initials: I
authors.lastname: Duarte
authors.forename: Macarena
authors.initials: M
authors.lastname: Jiménez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Pilar
authors.initials: P
authors.lastname: Domínguez
authors.forename: Javier
authors.initials: J
authors.lastname: Méndez
authors.forename: Alejandro
authors.initials: A
authors.lastname: Soza
authors.forename: Carlos
authors.initials: C
authors.lastname: Benitez
authors.forename: Rosa
authors.initials: R
authors.lastname: Pérez
authors.forename: Marco
authors.initials: M
authors.lastname: Arrese
authors.forename: Juan
authors.initials: J
authors.lastname: Guerra
authors.forename: Nicolás
authors.initials: N
authors.lastname: Jarufe
authors.forename: Jorge
authors.initials: J
authors.lastname: Martínez
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002677:Chile / Q000453:epidemiology; D046148:Donor Selection; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006498:Hepatectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D055815:Young Adult