ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Selectively Transplanting Moderately to Severely Macrosteatotic Grafts: Does Recipient Metabolic Environment Affect Outcomes?

P. J. Altshuler, A. Rios Diaz, O. Shaheen, A. P. Shah, W. R. Maley, A. Frank, C. Ramirez, J. Glorioso, H. Dang, A. S. Bodzin

Department of Surgery, Thomas Jefferson University, Philadelphia, PA

Meeting: 2020 American Transplant Congress

Abstract number: 44

Keywords: Donors, marginal, Dyslipidemia, Liver grafts, Metabolic disease

Session Information

Session Name: Liver: MELD, Allocation and Donor Issues (DCD/ECD) I

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 4:03pm-4:15pm

Location: Virtual

*Purpose: As incidence of Non-Alcoholic Steatohepatitis (NASH) cirrhosis rises, organ utilization remains stagnant. Recently, it has been shown that selective utilization of >30% macrosteatotic grafts can produce acceptable graft outcomes. We examine the effects of utilizing similarly metabolically impaired macrosteatotic donor grafts in NASH compared with non-NASH counterparts.

*Methods: Retrospective analysis of the Organ Procurement and Transplantation Network database from 2002 to 2019 identified 2,295 patients receiving >30% macrosteatotic grafts. Patients were stratified by diagnosis of NASH. Kaplan-Meier curves assessed survival with Cox proportional hazard and stratified log-rank tests assessing equality of survivor functions. Propensity score matching (PSM) addressed confounding variables.

*Results: NASH patients had higher unadjusted MELD scores (20 vs. 18, p<0.040), BMI (32 vs. 27, p<0.001), prevalence of diabetes (58.4% vs. 21.3%, p<0.001), portal vein thrombosis (PVT, 18.9 vs. 11.2%, p<0.001), and renal failure requiring dialysis (11.2% vs. 7.9%, p=0.046). PSM mitigated differences across MELD score, PVT, and renal failure, although trends in BMI and diabetes prevalence remained significant. PSM 1, 3 and 5-year patient survival were similar across NASH and non-NASH cohorts. Graft survival was similar at 1 and 3 years; however, NASH patients demonstrated significant improvement at 5 years. No difference was noted in mortality or graft failure on subgroup analysis including primary non-function (Figure 1).

*Conclusions: Despite differences in baseline characteristics and a more globally compromised profile, NASH patients tolerate macrosteatotic grafts as well as non-NASH counterparts. When matched, NASH demonstrated better 5-year survival with these grafts. Historically, transplants with >30% macrosteatotic grafts portend worse outcomes; short and long-term data here demonstrates these grafts have reasonable outcomes in populations with low incidences of primary non-function. These grafts can be safe to use in carefully selected donors in both NASH and non-NASH recipients.

 border=

PSM Baseline Characteristics and Outcomes in Transplants with Macrosteatotic Grafts
PSM Baseline Characteristics NASH Non-NASH p-value PSM Outcomes NASH Non-NASH p-value
Age 60 (55-65) 60 (52-64) 0.065 Survival: 1 year 308 (88.51%) 198 (90.00%) 0.679
BMI 32.1 (+/- 5.4) 27.9 (+/- 5.5) <0.001 3 years 301 (86.49%) 185 (84.09%) 0.463
Donor BMI 33.6 (+/- 7.9) 32.2 (+/- 7.8) 0.041 5 years 295 (84.77%) 175 (79.55%) 0.112
MELD 20 (15-25) 20 (15-26) 0.649 Graft Survival: 1 year 301 (86.49%) 189 (85.91%) 0.844
Diabetes 193 (58.31%) 40 (18.86%) <0.001 3 years 294 (84.48%) 174 (79.09%) 0.113
Renal Failure on Dialysis 39 (11.21%) 23 (10.45%) 0.780 5 years 288 (82.76%) 163 (74.09%) 0.013
Portal Vein Thrombosis 66 (19.02%) 42 (19.18%) 0.963 Graft Primary Non-Function 5 (1.44%) 6 (2.73%) 0.278
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Altshuler PJ, Diaz ARios, Shaheen O, Shah AP, Maley WR, Frank A, Ramirez C, Glorioso J, Dang H, Bodzin AS. Selectively Transplanting Moderately to Severely Macrosteatotic Grafts: Does Recipient Metabolic Environment Affect Outcomes? [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/selectively-transplanting-moderately-to-severely-macrosteatotic-grafts-does-recipient-metabolic-environment-affect-outcomes/. Accessed June 6, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences