Clinical surgery—International Effect of graft steatosis on liver function and organ survival after liver transplantation

Background: It was the aim to determine the effect of graft steatosis on intraoperative organ blood flow, postoperative liver function, and organ survival. Methods: A total of 225 consecutive liver transplants were reviewed. Liver blood flow, hepatic function (AST, ALT, prothrombin time), and organ survival were determined. Donor liver grafts were categorized into 2 subgroups: mild (30%) (n 175) and moderate to severe (30%) (n 50) macrovesicular steatosis. Results: Moderate to severe steatosis was associated with significantly increased AST and ALT levels and significantly diminished prothrombin time on the first and second postoperative day. By day 7 differences in liver function were no longer evident. Organ blood flow was not affected by steatosis. After adjustment for potential confounders, organ survival did not depend on the degree of donor steatosis (5-year-survival rates: 68% and 58% with steatosis 30%, or 30%, respectively) (hazard ratio .754, confidence interval .45 8–1.242, P .268). Conclusion: Steatotic livers can be transplanted safely with good results for long-term organ survival if other contraindications are absent. © 2008 Excerpta Medica Inc. All rights reserved.