title: Graft steatosis as a risk factor of ischemic-type biliary lesions in liver transplantation.
abstract: Ischemic-type biliary lesions (ITBLs) are now a discussed cause of morbidity and mortality in liver transplant recipients, even if not definitively characterized. We reviewed 13 years of donor and recipient data between April 2001 and April 2013. We evaluated the incidence of ITBL occurrence, exploring the possible predisposing factors, focusing on the relationship between severe macrovesicular steatosis of the graft and incidence of ITBL. A total of 445 grafts were harvested: 416 of them were transplanted at our institution, the remaining 29 were discarded by our donor team as showing more than 40% macrovesicular steatosis. Mild-moderate (20% to 40%) macrovesicular steatosis (P<.001) and cold ischemia time (P=.048) significantly increased the risk of ITBLs, also resulting in independent risk factors at multivariate analysis.
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: ffrongillo@yahoo.it.
authors.forename: F
authors.initials: F
authors.lastname: Frongillo
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Lirosi
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sganga
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Grossi
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Nure
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: A W
authors.initials: AW
authors.lastname: Avolio
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bianco
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mariano
authors.affiliation: Department of Surgery, Transplantation Service, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Agnes
mesh_terms: D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000453:epidemiology / Q000209:etiology*; D050377:Cold Ischemia / Q000009:adverse effects; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D015427:Reperfusion Injury / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014019:Tissue Donors