title: Oil Red O-assessed macrosteatosis in liver transplant donor biopsies predicts ischemia-reperfusion injury and clinical outcome.
abstract: Steatosis in donor livers is an accepted adverse prognostic factor after liver transplantation. While its semiquantitative assessment shows varying reproducibility, it is questioned as a standard method. Additionally, the influence of hepatic steatosis on ischemia/reperfusion injury (I/R injury) has not been evaluated in biopsies after reperfusion. We compared different staining and analyzing methods for the assessment of donor liver steatosis in order to predict I/R injury and clinical outcome after transplantation. To do this, 56 paired pre- and post-reperfusion liver biopsies were analyzed for macro- (MaS)/micro- (MiS) and total steatosis in cryo and permanent sections by special fat (Oil Red O or ORO) and standard stains. Computerized morphometrical analyses were compared to the semiquantitative assessment by a pathologist. I/R injury was determined histopathologically and by M30 immunohistochemistry. We found ORO to be more sensitive in detecting hepatic steatosis with higher reproducibility for MaS. Semiquantitative analyses were highly reproducible and not inferior to computerized morphometry. Categorized MaS as determined by ORO correlated with the extent of I/R injury, initial poor function, liver enzymes, and survival. Therefore fat stains like ORO are a reliable and easy method comprising significant advantages in the evaluation of hepatic steatosis and are thereby of prognostic value. Computerized analysis is a precise tool though not superior to semiquantitative analyses.
authors.affiliation: Institute of Pathology and Neuropathology, University Hospital of Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Reis
authors.forename: Patricia T
authors.initials: PT
authors.lastname: Peterek
authors.forename: Jeremias
authors.initials: J
authors.lastname: Wohlschlaeger
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Mathe
authors.forename: Benjamin
authors.initials: B
authors.lastname: Juntermanns
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beckhove
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wirges
authors.forename: Andre
authors.initials: A
authors.lastname: Scherag
authors.forename: Juergen-Walter
authors.initials: JW
authors.lastname: Treckmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Hideo Andreas
authors.initials: HA
authors.lastname: Baba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001391:Azo Compounds; D001706:Biopsy; D004396:Coloring Agents; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015427:Reperfusion Injury / Q000175:diagnosis*; D015203:Reproducibility of Results; D014019:Tissue Donors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001391:Azo Compounds; D004396:Coloring Agents; C011049:oil red O