Expanding Postmortem Donor Pool Using Steatotic Liver Grafts: A New Look

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dc.contributor.author Noujaim, Huda M.
dc.contributor.author Goyet, Jean de Ville de
dc.contributor.author Montero, Edna F. S. [UNIFESP]
dc.contributor.author Ribeiro, Cristiane M. F.
dc.contributor.author Capellozzi, Vera L.
dc.contributor.author Crescentini, Fabio
dc.contributor.author Casagrande, Matheo
dc.contributor.author Santos, Regina G.
dc.contributor.author Curvello, Lillian
dc.contributor.author Miranda, Marcelo P. de
dc.contributor.author Genzini, Tercio
dc.date.accessioned 2016-01-24T13:52:22Z
dc.date.available 2016-01-24T13:52:22Z
dc.date.issued 2009-03-27
dc.identifier http://dx.doi.org/10.1097/TP.0b013e31819b3f76
dc.identifier.citation Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 87, n. 6, p. 919-925, 2009.
dc.identifier.issn 0041-1337
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/31389
dc.description.abstract Background. Clinical demand for liver transplant steadily grows while organs offer has reached a plateau years ago. To expand the donor liver pool, various options have been considered including acceptance of suboptimal donors and steatotic grafts, with a risk of poorer outcomes. the latter risk and its relation to the grade of liver graft steatosis have been studied in this prospective clinical study.Methods. One hundred eighteen consecutive liver transplantation (115 patients) performed between May 2002 and March 2008 were prospectively analyzed. According to the grade of steatosis on a 2 hr postreperfusion biopsy, four groups were considered: absence (<5%) (n=34), mild (<30%) (n=40), moderate (30%-60%) (n=23), or severe steatosis (>= 60%) (n=21). Donors and recipients demographic data, and patients and grafts survival rates were compared among the four groups.Results. Eighty-four (71%) grafts presented some degree of steatosis (macrosteatosis: 19.5%, microsteatosis: 47%, mix type: 33.5%). Patient and graft survival were significant lower in the severe steatosis group, as a whole. Grafts with less than 30% predominant macro-, or microsteatosis also had poorer outcomes with lower patient and graft survival rates.Conclusion. Steatotic liver grafts were used on a large scale (71%) in this clinical series. the analysis confirms that using grafts with moderate (>30%) and severe steatosis (>60%) have a negative impact on outcomes. the authors conclude that using these grafts allow a significant increase in organ offer that counterbalances the negative outcome for patients who are not offered a transplant, and this supports the need for further clinical research. en
dc.format.extent 919-925
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.relation.ispartof Transplantation
dc.rights Acesso restrito
dc.subject Hepatic steatosis en
dc.subject Marginal donors en
dc.subject Liver transplant en
dc.subject Donor pool en
dc.subject Outcome en
dc.title Expanding Postmortem Donor Pool Using Steatotic Liver Grafts: A New Look en
dc.type Artigo
dc.contributor.institution HEPATO Hosp Beneficencia Portuguesa São Paulo
dc.contributor.institution Osped Pediat Bambino Gesu Roma
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution CIP Hosp Beneficencia Portuguesa São Paulo
dc.contributor.institution Universidade de São Paulo (USP)
dc.description.affiliation HEPATO Hosp Beneficencia Portuguesa São Paulo, São Paulo, Brazil
dc.description.affiliation Osped Pediat Bambino Gesu Roma, Dept Hepatogastroenterol & Nutr, Rome, Italy
dc.description.affiliation Universidade Federal de São Paulo, Disciplina Cirurgia Expt, São Paulo, Brazil
dc.description.affiliation CIP Hosp Beneficencia Portuguesa São Paulo, São Paulo, Brazil
dc.description.affiliation FMUSP, Lab Imunohistoquim, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Disciplina Cirurgia Expt, São Paulo, Brazil
dc.identifier.doi 10.1097/TP.0b013e31819b3f76
dc.description.source Web of Science
dc.identifier.wos WOS:000264509900020



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