Use of steatotic graft in living-donor liver transplantation

Yuji Soejima, Mitsuo Shimada, Taketoshi Suehiro, Keiji Kishikawa, Tomoharu Yoshizumi, Koji Hashimoto, Ryosuke Minagawa, Shoji Hiroshige, Takahiro Terashi, Mizuki Ninomiya, Satoko Shiotani, Noboru Harada, Keizo Sugimachi

Research output: Contribution to journalArticle

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Abstract

Background. The degree of fatty infiltration in hepatic grafts is known to be an important risk factor for primary graft nonfunction in cadaveric liver transplantation. However, the effect of hepatic steatosis in living-donor liver transplantation (LDLT) has not yet been well defined. In this study, we evaluated the impact that the degree of hepatic graft steatosis has on the outcome of LDLT. Methods. Sixty consecutive donors and recipients who underwent LDLT between October 1996 and August 2001 at Kyushu University Hospital were the subjects of this study. The pathologic findings of the prereperfusion biopsy of the graft were classified into the following three groups according to the degree of macrovesicular steatosis: None (n=23), 0% steatosis; Mild (n=23), 0% to 20% steatosis; and Moderate (n=6), 20% to 50% steatosis. Liver function tests including total bilirubin (at postoperative day [POD] 7), the peak alanine aminotransferase (ALT) and prothrombin time (at POD 3), and both patient and graft survival were compared among the groups. Furthermore, we also compared the donor parameters including the peak ALT and total bilirubin (at POD 3) and the operative time, blood loss, and length of hospital stay after surgery. Results. The 1-year patient and graft survival were comparable among the groups. The peak ALT was significantly higher in the Moderate group (606±641 IU/L) than in the None (290±190 IU/L) and Mild (376±296 IU/L) groups. Total bilirubin (POD 7) and prothrombin time (POD 3) were comparable among the groups. The donor parameters were comparable among the groups except for the fact that the donor body weight of the Mild and Moderate groups were significantly heavier (P<0.0001) than that of the None group. Conclusions. In conclusion, the use of a fatty liver graft up to the moderate level can be justified in LDLT, even though ischemia-reperfusion injury tends to be severe in such grafts.

Original languageEnglish
Pages (from-to)344-348
Number of pages5
JournalTransplantation
Volume76
Issue number2
DOIs
Publication statusPublished - Jul 27 2003

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Living Donors
Liver Transplantation
Transplants
Alanine Transaminase
Bilirubin
Tissue Donors
Prothrombin Time
Graft Survival
Liver
Length of Stay
Liver Function Tests
Fatty Liver
Operative Time
Reperfusion Injury
Body Weight
Biopsy

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Soejima, Y., Shimada, M., Suehiro, T., Kishikawa, K., Yoshizumi, T., Hashimoto, K., ... Sugimachi, K. (2003). Use of steatotic graft in living-donor liver transplantation. Transplantation, 76(2), 344-348. https://doi.org/10.1097/01.TP.0000071205.52835.A4

Use of steatotic graft in living-donor liver transplantation. / Soejima, Yuji; Shimada, Mitsuo; Suehiro, Taketoshi; Kishikawa, Keiji; Yoshizumi, Tomoharu; Hashimoto, Koji; Minagawa, Ryosuke; Hiroshige, Shoji; Terashi, Takahiro; Ninomiya, Mizuki; Shiotani, Satoko; Harada, Noboru; Sugimachi, Keizo.

In: Transplantation, Vol. 76, No. 2, 27.07.2003, p. 344-348.

Research output: Contribution to journalArticle

Soejima, Y, Shimada, M, Suehiro, T, Kishikawa, K, Yoshizumi, T, Hashimoto, K, Minagawa, R, Hiroshige, S, Terashi, T, Ninomiya, M, Shiotani, S, Harada, N & Sugimachi, K 2003, 'Use of steatotic graft in living-donor liver transplantation', Transplantation, vol. 76, no. 2, pp. 344-348. https://doi.org/10.1097/01.TP.0000071205.52835.A4
Soejima Y, Shimada M, Suehiro T, Kishikawa K, Yoshizumi T, Hashimoto K et al. Use of steatotic graft in living-donor liver transplantation. Transplantation. 2003 Jul 27;76(2):344-348. https://doi.org/10.1097/01.TP.0000071205.52835.A4
Soejima, Yuji ; Shimada, Mitsuo ; Suehiro, Taketoshi ; Kishikawa, Keiji ; Yoshizumi, Tomoharu ; Hashimoto, Koji ; Minagawa, Ryosuke ; Hiroshige, Shoji ; Terashi, Takahiro ; Ninomiya, Mizuki ; Shiotani, Satoko ; Harada, Noboru ; Sugimachi, Keizo. / Use of steatotic graft in living-donor liver transplantation. In: Transplantation. 2003 ; Vol. 76, No. 2. pp. 344-348.
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AU - Soejima, Yuji

AU - Shimada, Mitsuo

AU - Suehiro, Taketoshi

AU - Kishikawa, Keiji

AU - Yoshizumi, Tomoharu

AU - Hashimoto, Koji

AU - Minagawa, Ryosuke

AU - Hiroshige, Shoji

AU - Terashi, Takahiro

AU - Ninomiya, Mizuki

AU - Shiotani, Satoko

AU - Harada, Noboru

AU - Sugimachi, Keizo

PY - 2003/7/27

Y1 - 2003/7/27

N2 - Background. The degree of fatty infiltration in hepatic grafts is known to be an important risk factor for primary graft nonfunction in cadaveric liver transplantation. However, the effect of hepatic steatosis in living-donor liver transplantation (LDLT) has not yet been well defined. In this study, we evaluated the impact that the degree of hepatic graft steatosis has on the outcome of LDLT. Methods. Sixty consecutive donors and recipients who underwent LDLT between October 1996 and August 2001 at Kyushu University Hospital were the subjects of this study. The pathologic findings of the prereperfusion biopsy of the graft were classified into the following three groups according to the degree of macrovesicular steatosis: None (n=23), 0% steatosis; Mild (n=23), 0% to 20% steatosis; and Moderate (n=6), 20% to 50% steatosis. Liver function tests including total bilirubin (at postoperative day [POD] 7), the peak alanine aminotransferase (ALT) and prothrombin time (at POD 3), and both patient and graft survival were compared among the groups. Furthermore, we also compared the donor parameters including the peak ALT and total bilirubin (at POD 3) and the operative time, blood loss, and length of hospital stay after surgery. Results. The 1-year patient and graft survival were comparable among the groups. The peak ALT was significantly higher in the Moderate group (606±641 IU/L) than in the None (290±190 IU/L) and Mild (376±296 IU/L) groups. Total bilirubin (POD 7) and prothrombin time (POD 3) were comparable among the groups. The donor parameters were comparable among the groups except for the fact that the donor body weight of the Mild and Moderate groups were significantly heavier (P<0.0001) than that of the None group. Conclusions. In conclusion, the use of a fatty liver graft up to the moderate level can be justified in LDLT, even though ischemia-reperfusion injury tends to be severe in such grafts.

AB - Background. The degree of fatty infiltration in hepatic grafts is known to be an important risk factor for primary graft nonfunction in cadaveric liver transplantation. However, the effect of hepatic steatosis in living-donor liver transplantation (LDLT) has not yet been well defined. In this study, we evaluated the impact that the degree of hepatic graft steatosis has on the outcome of LDLT. Methods. Sixty consecutive donors and recipients who underwent LDLT between October 1996 and August 2001 at Kyushu University Hospital were the subjects of this study. The pathologic findings of the prereperfusion biopsy of the graft were classified into the following three groups according to the degree of macrovesicular steatosis: None (n=23), 0% steatosis; Mild (n=23), 0% to 20% steatosis; and Moderate (n=6), 20% to 50% steatosis. Liver function tests including total bilirubin (at postoperative day [POD] 7), the peak alanine aminotransferase (ALT) and prothrombin time (at POD 3), and both patient and graft survival were compared among the groups. Furthermore, we also compared the donor parameters including the peak ALT and total bilirubin (at POD 3) and the operative time, blood loss, and length of hospital stay after surgery. Results. The 1-year patient and graft survival were comparable among the groups. The peak ALT was significantly higher in the Moderate group (606±641 IU/L) than in the None (290±190 IU/L) and Mild (376±296 IU/L) groups. Total bilirubin (POD 7) and prothrombin time (POD 3) were comparable among the groups. The donor parameters were comparable among the groups except for the fact that the donor body weight of the Mild and Moderate groups were significantly heavier (P<0.0001) than that of the None group. Conclusions. In conclusion, the use of a fatty liver graft up to the moderate level can be justified in LDLT, even though ischemia-reperfusion injury tends to be severe in such grafts.

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