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Effect of donor graft hepatosteatosis on postoperative complications in adult living donor liver transplant recipients

Yıl 2024, Cilt: 23 Sayı: 1, 13 - 19, 25.04.2024
https://doi.org/10.17941/agd.1459441

Öz

Background and Aims: Steatosis is one of today's important and common donor liver problems, affecting graft function to varying degrees and leading to marginal graft failure. We examined the effect of graft steatosis on postoperative complications, in our study. Material and Methods: One hundred forty eight donors and adult living donor liver transplant recipients who underwent transplantation were included in the study. The numbers and rates of perioperative blood product transfusion, postoperative biliary complications, hepatic vein thrombosis, portal vein thrombosis, postoperative bleeding, sepsis and primary graft dysfunction were analyzed statistically. Results: Early postoperative intra-abdominal bleeding was observed to be more common in fatty grafts, with a rate of 10.5%, than in non-fat grafts, with a rate of 4.5%. There was no statistically significant difference between those with and without donor graft steatosis. Conclusion: Although not statistically significant, the high rate of postoperative intra-abdominal bleeding in fatty grafts may be an important finding.

Kaynakça

  • 1. Ahmed EA, El-Badry AM, Mocchegiani F, et al. Impact of Graft Steatosis on Postoperative Complications after Liver Transplantation. Surg J (N Y). 2018;4(4):e188-e196.
  • 2. Machado MV, Cortez-Pinto H. Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol. 2013;58(5):1007-19.
  • 3. Todo S, Demetris AJ, Makowka L, et al. Primary nonfunction of hepatic allografts with preexisting fatty infiltration. Transplantation. 1989;47(5):903-5.
  • 4. Fujii Y, Kawamura N, Zaitsu M, et al. Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver. Ann Transplant. 2020;25:e920677.
  • 5. de Graaf EL, Kench J, Dilworth P, et al. Grade of deceased donor liver macrovesicular steatosis impacts graft and recipient outcomes more than the Donor Risk Index. J Gastroenterol Hepatol. 2012;27(3):540-6.
  • 6. İdilman İS, Karçaaltıncaba M. Karaciğer Yağlanması Tanısında Ve Yağlanma Miktarının Belirlenmesinde Radyolojik Tanı Yöntemleri. Güncel Gastroenteroloji 2014;18(1):112-8.
  • 7. Wells MM, Li Z, Addeman B, et al. Computed Tomography Measurement of Hepatic Steatosis: Prevalence of Hepatic Steatosis in a Canadian Population. Can J Gastroenterol Hepatol. 2016;2016:4930987.
  • 8. Li HY, Wei YG, Li B, et al. Impact of graft steatosis on the post-transplantation biliary complications for living donor liver transplant recipients in China. Hepatogastroenterology. 2012;59(116):1194-7.
  • 9. Zhao X, He Y, Liu J, et al. Impact of living donor liver with steatosis and idiopathic portal inflammation on clinical outcomes in pediatric liver transplantation: Beijing experience. Hepatobiliary Surg Nutr. 2022;11(3):340-54.
  • 10. Cho JY, Suh KS, Lee HW, et al. Hepatic steatosis is associated with intrahepatic cholestasis and transient hyperbilirubinemia during regeneration after living donor liver transplantation. Transpl Int. 2006;19(10):807-13.
  • 11. Han S, Ko JS, Kwon G, et al. Effect of pure microsteatosis on transplant outcomes after living donor liver transplantation: a matched case-control study. Liver Transpl. 2014;20(4):473-82.
  • 12. Yoon YI, Song GW, Lee SG, et al. Safe use of right lobe living donor livers with moderate steatosis in adult-to-adult living donor liver transplantation: a retrospective study. Transpl Int. 2021;34(5):872-81.
  • 13. Bhangui P, Sah J, Choudhary N, et al. Safe Use of Right Lobe Live Donor Livers With up to 20% Macrovesicular Steatosis Without Compromising Donor Safety and Recipient Outcome. Transplantation. 2020;104(2):308-16.
  • 14. Choi WT, Jen KY, Wang D, et al. Donor Liver Small Droplet Macrovesicular Steatosis Is Associated With Increased Risk for Recipient Allograft Rejection. Am J Surg Pathol. 2017;41(3):365-73.
  • 15. Salizzoni M, Franchello A, Zamboni F, et al. Marginal grafts: finding the correct treatment for fatty livers. Transpl Int. 2003;16(7):486-93.
  • 16. Zamboni F, Franchello A, David E, et al. Effect of macrovescicular steatosis and other donor and recipient characteristics on the outcome of liver transplantation. Clin Transplant. 2001;15(1):53-7.
  • 17. Angelico M. Donor liver steatosis and graft selection for liver transplantation: a short review. Eur Rev Med Pharmacol Sci. 2005;9(5):295-7.
  • 18. McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver transplantation using fatty livers: always feasible? J Hepatol. 2011;54(5):1055-62.
  • 19. Da BL, Satiya J, Heda RP, et al. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. Euroasian J Hepatogastroenterol. 2022;12(Suppl 1):S5-S14.
  • 20. Sharkey FE, Lytvak I, Prihoda TJ, et al. High-grade microsteatosis and delay in hepatic function after orthotopic liver transplantation. Hum Pathol. 2011;42:1337-42.

Donör graft hepatosteatozunun yetişkin canlı donör karaciğer nakli alıcılarında ameliyat sonrası komplikasyonlara etkisi

Yıl 2024, Cilt: 23 Sayı: 1, 13 - 19, 25.04.2024
https://doi.org/10.17941/agd.1459441

Öz

Giriş ve Amaç: Steatoz, greft fonksiyonunu değişen derecelerde etkileyen ve marjinal greft yetmezliğine neden olan günümüzün önemli ve yaygın donör karaciğer problemlerinden biridir. Çalışmamızda, greft steatozunun postoperatif komplikasyonlara etkisini inceledik. Gereç ve Yöntem: Çalışmaya 148 donör ve transplantasyon yapılan yetişkin canlı donör karaciğer nakli alıcısı dahil edildi. Perioperatif kan ürünü transfüzyonu, postoperatif safra komplikasyonları, hepatik ven trombozu, portal ven trombozu, postoperatif kanama, sepsis ve primer greft disfonksiyonu sayıları ve oranları istatistiksel olarak analiz edildi. Bulgular: Ameliyat sonrası erken dönemde intraabdominal kanamanın yağlı greftlerde oran olarak, yağsız greftlere göre daha sık olduğu görüldü. Donör greft steatozu olan ve olmayanlar arasında tüm parametreler açısından istatistiksel olarak anlamlı fark yoktu. Sonuç: İstatistiksel olarak anlamlı olmasa da yağlı greftlerde ameliyat sonrası intraabdominal kanama oranının yüksek olması önemli bir bulgu olabilir.

Kaynakça

  • 1. Ahmed EA, El-Badry AM, Mocchegiani F, et al. Impact of Graft Steatosis on Postoperative Complications after Liver Transplantation. Surg J (N Y). 2018;4(4):e188-e196.
  • 2. Machado MV, Cortez-Pinto H. Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol. 2013;58(5):1007-19.
  • 3. Todo S, Demetris AJ, Makowka L, et al. Primary nonfunction of hepatic allografts with preexisting fatty infiltration. Transplantation. 1989;47(5):903-5.
  • 4. Fujii Y, Kawamura N, Zaitsu M, et al. Outcome of Living-Donor Liver Transplantation Using Grafts from Donors Treated for Fatty Liver. Ann Transplant. 2020;25:e920677.
  • 5. de Graaf EL, Kench J, Dilworth P, et al. Grade of deceased donor liver macrovesicular steatosis impacts graft and recipient outcomes more than the Donor Risk Index. J Gastroenterol Hepatol. 2012;27(3):540-6.
  • 6. İdilman İS, Karçaaltıncaba M. Karaciğer Yağlanması Tanısında Ve Yağlanma Miktarının Belirlenmesinde Radyolojik Tanı Yöntemleri. Güncel Gastroenteroloji 2014;18(1):112-8.
  • 7. Wells MM, Li Z, Addeman B, et al. Computed Tomography Measurement of Hepatic Steatosis: Prevalence of Hepatic Steatosis in a Canadian Population. Can J Gastroenterol Hepatol. 2016;2016:4930987.
  • 8. Li HY, Wei YG, Li B, et al. Impact of graft steatosis on the post-transplantation biliary complications for living donor liver transplant recipients in China. Hepatogastroenterology. 2012;59(116):1194-7.
  • 9. Zhao X, He Y, Liu J, et al. Impact of living donor liver with steatosis and idiopathic portal inflammation on clinical outcomes in pediatric liver transplantation: Beijing experience. Hepatobiliary Surg Nutr. 2022;11(3):340-54.
  • 10. Cho JY, Suh KS, Lee HW, et al. Hepatic steatosis is associated with intrahepatic cholestasis and transient hyperbilirubinemia during regeneration after living donor liver transplantation. Transpl Int. 2006;19(10):807-13.
  • 11. Han S, Ko JS, Kwon G, et al. Effect of pure microsteatosis on transplant outcomes after living donor liver transplantation: a matched case-control study. Liver Transpl. 2014;20(4):473-82.
  • 12. Yoon YI, Song GW, Lee SG, et al. Safe use of right lobe living donor livers with moderate steatosis in adult-to-adult living donor liver transplantation: a retrospective study. Transpl Int. 2021;34(5):872-81.
  • 13. Bhangui P, Sah J, Choudhary N, et al. Safe Use of Right Lobe Live Donor Livers With up to 20% Macrovesicular Steatosis Without Compromising Donor Safety and Recipient Outcome. Transplantation. 2020;104(2):308-16.
  • 14. Choi WT, Jen KY, Wang D, et al. Donor Liver Small Droplet Macrovesicular Steatosis Is Associated With Increased Risk for Recipient Allograft Rejection. Am J Surg Pathol. 2017;41(3):365-73.
  • 15. Salizzoni M, Franchello A, Zamboni F, et al. Marginal grafts: finding the correct treatment for fatty livers. Transpl Int. 2003;16(7):486-93.
  • 16. Zamboni F, Franchello A, David E, et al. Effect of macrovescicular steatosis and other donor and recipient characteristics on the outcome of liver transplantation. Clin Transplant. 2001;15(1):53-7.
  • 17. Angelico M. Donor liver steatosis and graft selection for liver transplantation: a short review. Eur Rev Med Pharmacol Sci. 2005;9(5):295-7.
  • 18. McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver transplantation using fatty livers: always feasible? J Hepatol. 2011;54(5):1055-62.
  • 19. Da BL, Satiya J, Heda RP, et al. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. Euroasian J Hepatogastroenterol. 2022;12(Suppl 1):S5-S14.
  • 20. Sharkey FE, Lytvak I, Prihoda TJ, et al. High-grade microsteatosis and delay in hepatic function after orthotopic liver transplantation. Hum Pathol. 2011;42:1337-42.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Gastroenteroloji ve Hepatoloji
Bölüm Makaleler
Yazarlar

Ender Anılır 0000-0002-0024-1790

Feyza Sönmez Topcu

Emrah Şahin

Alihan Oral 0000-0003-1160-9340

Esra Güzelaltunçekiç 0009-0008-0200-5936

Abuzer Dirican 0000-0002-8647-3268

Bülent Ünal 0000-0003-2538-7961

Yayımlanma Tarihi 25 Nisan 2024
Gönderilme Tarihi 31 Ekim 2023
Kabul Tarihi 10 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 23 Sayı: 1

Kaynak Göster

APA Anılır, E., Sönmez Topcu, F., Şahin, E., Oral, A., vd. (2024). Donör graft hepatosteatozunun yetişkin canlı donör karaciğer nakli alıcılarında ameliyat sonrası komplikasyonlara etkisi. Akademik Gastroenteroloji Dergisi, 23(1), 13-19. https://doi.org/10.17941/agd.1459441

test-5