Primary Non-Function of Hepatic Allograft With Preexisting Microvesicular Steatosis/Foamy Degeneration and Mild Large-Droplet Macrovesicular Steatosis

Melissa E. Limia, Xiu Li Liu, Jennifer Yu, Kathleen Byrnes

Research output: Contribution to journalArticlepeer-review

Abstract

It has been established that more than mild large-droplet macrovesicular steatosis (LD-MAS) is associated with increased risk of graft nonfunction. In contrast, even severe small-droplet macrovesicular steatosis (SD-MAS) has been found to be less prognostically significant. It remains unclear if a donor liver with diffuse microvesicular steatosis is associated with an increased risk of graft dysfunction. A 56-year-old male with alcoholic cirrhosis was transplanted with a liver from a 42-year-old overweight male donor after brain death. The frozen section of the donor liver biopsy taken at harvest showed diffusely enlarged clear/foamy hepatocytes and mild LD-MAS (about 5-10% of total tissue). The reperfusion liver biopsy taken at time 0 of transplantation showed hemorrhage, pale and enlarged hepatocytes, and mild LD-MAS (about 10% of total tissue) with lipopeliosis. The graft became non-functional, and the patient was re-transplanted 24 h after the initial transplantation. Histologic examination of the failed liver allograft showed extensive hemorrhagic necrosis, neutrophilic inflammation, diffuse microvesicular steatosis, and large extracellular fat droplets (about 20% of total tissue). This case demonstrates that precautions are needed to avoid using livers with diffuse and severe microvesicular steatosis.

Original languageEnglish
Pages (from-to)37-40
Number of pages4
JournalGastroenterology Research
Volume17
Issue number1
DOIs
StatePublished - Feb 2024

Keywords

  • Donor liver
  • Foamy degeneration
  • Frozen section
  • Largedroplet macrovesicular steatosis
  • Liver transplant
  • Microvesicular steatosis
  • Primary nonfunction

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