The histological assessment of liver fibrosis in grafts from extended criteria donors predicts the outcome after liver transplantation: A retrospective study.
Adult
Aged
Cause of Death
Donor Selection
/ standards
Dyslipidemias
/ epidemiology
Female
Graft Survival
Humans
Incidence
Italy
/ epidemiology
Liver Cirrhosis
/ pathology
Liver Transplantation
/ adverse effects
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
Young Adult
Dyslipidemic donor
Early allograft dysfunction
Histopathology
Portal fibrosis
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
07
01
2019
revised:
07
04
2019
accepted:
04
05
2019
pubmed:
4
6
2019
medline:
16
12
2020
entrez:
4
6
2019
Statut:
ppublish
Résumé
The use of extended criteria donors (ECD) in liver transplantation is increasing due to the organ shortage. Histological evaluation of the liver graft in the context of procurement is an important tool for extending the donor pool without affecting the quality of the transplanted organs. Macrovesicular steatosis is widely accepted as predictor of early allograft dysfunction (EAD), while other features, such as portal fibrosis, are poorly studied. To identify morphological features, other than macrovesicular steatosis, that may affect recipients' outcome. Between 2014 and 2016, 132 donors with extended criteria underwent pre-transplant liver biopsy during procurement. Histological variables of the graft, donors'/recipients' clinical data, EAD and patient/graft survival were registered. The recipients who received a graft with histological-proven portal fibrosis had a significant lower patient and graft survival in comparison to patients without fibrosis (P = 0.044 and P = 0.039, respectively). Donors' dyslipidemia was significantly associated with the occurrence of EAD (P = 0.021). When dyslipidemia was combined with histological liver fibrosis a 54.5% incidence of EAD was observed (P = 0.012). The histological assessment of liver fibrosis in pre-transplant biopsy of ECD grafts, together with donor's clinical data, provides important information on recipients' outcome.
Sections du résumé
BACKGROUND
The use of extended criteria donors (ECD) in liver transplantation is increasing due to the organ shortage. Histological evaluation of the liver graft in the context of procurement is an important tool for extending the donor pool without affecting the quality of the transplanted organs. Macrovesicular steatosis is widely accepted as predictor of early allograft dysfunction (EAD), while other features, such as portal fibrosis, are poorly studied.
AIM
To identify morphological features, other than macrovesicular steatosis, that may affect recipients' outcome.
METHODS
Between 2014 and 2016, 132 donors with extended criteria underwent pre-transplant liver biopsy during procurement. Histological variables of the graft, donors'/recipients' clinical data, EAD and patient/graft survival were registered.
RESULTS
The recipients who received a graft with histological-proven portal fibrosis had a significant lower patient and graft survival in comparison to patients without fibrosis (P = 0.044 and P = 0.039, respectively). Donors' dyslipidemia was significantly associated with the occurrence of EAD (P = 0.021). When dyslipidemia was combined with histological liver fibrosis a 54.5% incidence of EAD was observed (P = 0.012).
CONCLUSIONS
The histological assessment of liver fibrosis in pre-transplant biopsy of ECD grafts, together with donor's clinical data, provides important information on recipients' outcome.
Identifiants
pubmed: 31155489
pii: S1590-8658(19)30592-4
doi: 10.1016/j.dld.2019.05.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-189Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.