Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients
Background. No data are available on liver transplantation (LT) outcome and donor liver steatosis, classified as large droplet macrovesicular (Ld-MaS), small-droplet macrovesicular (Sd-MaS), and true microvesicular (MiS), taking into account the recipient Hepatitis C virus (HCV) status. Aim. We inve...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/5862985 |
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| author | Flaminia Ferri Quirino Lai Antonio Molinaro Edoardo Poli Lucia Parlati Barbara Lattanzi Gianluca Mennini Fabio Melandro Francesco Pugliese Federica Maldarelli Alessandro Corsi Mara Riminucci Manuela Merli Massimo Rossi Stefano Ginanni Corradini |
| author_facet | Flaminia Ferri Quirino Lai Antonio Molinaro Edoardo Poli Lucia Parlati Barbara Lattanzi Gianluca Mennini Fabio Melandro Francesco Pugliese Federica Maldarelli Alessandro Corsi Mara Riminucci Manuela Merli Massimo Rossi Stefano Ginanni Corradini |
| author_sort | Flaminia Ferri |
| collection | DOAJ |
| description | Background. No data are available on liver transplantation (LT) outcome and donor liver steatosis, classified as large droplet macrovesicular (Ld-MaS), small-droplet macrovesicular (Sd-MaS), and true microvesicular (MiS), taking into account the recipient Hepatitis C virus (HCV) status. Aim. We investigate the impact of allograft steatosis reclassified according to the Brunt classification on early graft function and survival after LT. Methods. We retrospectively reviewed 204 consecutive preischemia biopsies of grafts transplanted in our center during the period 2001-2011 according to recipient HCV status. Results. The median follow-up after LT was 7.5 years (range: 0.0-16.7). In negative recipients (n=122), graft loss was independently associated with graft Sd-MaS, in multivariable Cox regression models comprehending only pre-/intraoperative variables (HR=1.03, 95%CI=1.01-1.05; P=0.003) and when including indexes of early postoperative graft function (HR=1.04, 95%CI=1.02-1.06; P=0.001). Graft Sd-MaS>15% showed a risk for graft loss > 2.5-folds in both the models. Graft Sd-MaS>15% was associated with reduced graft ATP content and, only in HCV- recipients, with higher early post-LT serum AST peaks. Conclusions. In HCV-negative recipients, allografts with >15% Sd-MaS have significantly reduced graft survival and show low ATP and higher AST peaks in the immediate posttransplant period. Donors with >15% Sd-MaS have significantly higher BMI, longer ICU stays, and lower PaO2. |
| format | Article |
| id | doaj-art-f9da48b03a104c59a60ebc27eba156d2 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-f9da48b03a104c59a60ebc27eba156d22025-02-03T01:12:20ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/58629855862985Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative RecipientsFlaminia Ferri0Quirino Lai1Antonio Molinaro2Edoardo Poli3Lucia Parlati4Barbara Lattanzi5Gianluca Mennini6Fabio Melandro7Francesco Pugliese8Federica Maldarelli9Alessandro Corsi10Mara Riminucci11Manuela Merli12Massimo Rossi13Stefano Ginanni Corradini14Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyHepato-Bilio-Pancreatic and Liver Transplant Unit Department of Surgery, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Molecular and Clinical Medicine, University of Gothenburg, and Sahlgrenska University Hospital, 405 30 Gothenburg, SwedenCentre Hepato-Biliaire, Hôpital Paul Brousse, AP-HP, 94800 Villejuif, FranceHepatology Department, Université Paris Descartes, Cochin Hospital, AP-HP, 75014 Paris, FranceDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyHepato-Bilio-Pancreatic and Liver Transplant Unit Department of Surgery, Sapienza University of Rome, 00161 Rome, ItalyHepato-Bilio-Pancreatic and Liver Transplant Unit Department of Surgery, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Anaesthesiology Critical Care Medicine and Pain Therapy, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Anaesthesiology Critical Care Medicine and Pain Therapy, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Molecular Medicine, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Molecular Medicine, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyHepato-Bilio-Pancreatic and Liver Transplant Unit Department of Surgery, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, ItalyBackground. No data are available on liver transplantation (LT) outcome and donor liver steatosis, classified as large droplet macrovesicular (Ld-MaS), small-droplet macrovesicular (Sd-MaS), and true microvesicular (MiS), taking into account the recipient Hepatitis C virus (HCV) status. Aim. We investigate the impact of allograft steatosis reclassified according to the Brunt classification on early graft function and survival after LT. Methods. We retrospectively reviewed 204 consecutive preischemia biopsies of grafts transplanted in our center during the period 2001-2011 according to recipient HCV status. Results. The median follow-up after LT was 7.5 years (range: 0.0-16.7). In negative recipients (n=122), graft loss was independently associated with graft Sd-MaS, in multivariable Cox regression models comprehending only pre-/intraoperative variables (HR=1.03, 95%CI=1.01-1.05; P=0.003) and when including indexes of early postoperative graft function (HR=1.04, 95%CI=1.02-1.06; P=0.001). Graft Sd-MaS>15% showed a risk for graft loss > 2.5-folds in both the models. Graft Sd-MaS>15% was associated with reduced graft ATP content and, only in HCV- recipients, with higher early post-LT serum AST peaks. Conclusions. In HCV-negative recipients, allografts with >15% Sd-MaS have significantly reduced graft survival and show low ATP and higher AST peaks in the immediate posttransplant period. Donors with >15% Sd-MaS have significantly higher BMI, longer ICU stays, and lower PaO2.http://dx.doi.org/10.1155/2019/5862985 |
| spellingShingle | Flaminia Ferri Quirino Lai Antonio Molinaro Edoardo Poli Lucia Parlati Barbara Lattanzi Gianluca Mennini Fabio Melandro Francesco Pugliese Federica Maldarelli Alessandro Corsi Mara Riminucci Manuela Merli Massimo Rossi Stefano Ginanni Corradini Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients Canadian Journal of Gastroenterology and Hepatology |
| title | Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients |
| title_full | Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients |
| title_fullStr | Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients |
| title_full_unstemmed | Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients |
| title_short | Donor Small-Droplet Macrovesicular Steatosis Affects Liver Transplant Outcome in HCV-Negative Recipients |
| title_sort | donor small droplet macrovesicular steatosis affects liver transplant outcome in hcv negative recipients |
| url | http://dx.doi.org/10.1155/2019/5862985 |
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