Session Time: 3:15pm-4:45pm
Presentation Time: 4:27pm-4:39pm
*Purpose: The number of steatotic deceased donor livers encountered has continued to rise as a result of the obesity epidemic. Little is known about the histological characteristics of moderately macrosteatotic livers over time in the recipient following liver transplantation (LT).
*Methods: All recipients undergoing LT at Mayo Clinic Florida (MCF) with donor livers with moderate macrosteatosis (30-60%) from 2000-2017 were identified (N=96). Routine protocol liver biopsies were performed 1 week and 6 months following LT. All liver donor and protocol biopsies were read by an experienced liver pathologist at MCF.
*Results: Of the 96 moderate macrosteatosis LTs, 70 recipients had post-LT protocol liver biopsies available and therefore comprised the study cohort. Median donor allograft macrosteatosis at the time of transplant was 33% (IQR 30-40%) compared to 0% (IQR 0-2%) at 1 week (p<0.001) and 0% (IQR 0-0%) at 6 months (p<0.001) following LT. Biopsies at 1 week post-LT displayed pericentral necrosis in 57.1% of recipients and lipopeliosis in 34.3% of recipients. In the 6 month post-LT biopsies cholestasis was seen in 3 (4.3%) of recipients, while grade 2 fibrosis was seen in 6 recipients (8.6%). Graft survival at 5 years in the present cohort was 75.3%.
*Conclusions: Moderate Macrosteatosis (30-60%) in the donor allograft demonstrates complete reversal on liver biopsies performed as early as 7 days following LT and remains absent at 6 months following LT. Both pericentral necrosis and lipopeliosis are common features on day 7 biopsies. Longterm graft survival is excellent in recipients who are able to overcome the immediate perioperative risk of utilizing moderately steatotic donor livers.
To cite this abstract in AMA style:Croome K, Livingston D, Taner C, Nakhleh R. Sequential Protocol Biopsies Post-Liver Transplant from Donors with Moderate Macrosteatosis: What Happens to the Fat? [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/sequential-protocol-biopsies-post-liver-transplant-from-donors-with-moderate-macrosteatosis-what-happens-to-the-fat/. Accessed March 4, 2021.
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