Impact of living donor liver with steatosis and idiopathic portal inflammation on clinical outcomes in pediatric liver transplantation: Beijing experience.

Abstract

Background:

To evaluate the impact of steatosis and/or idiopathic portal inflammation (IPI) in living donor livers on recipients' clinical outcomes.

Methods:

We assessed 305 qualified donor liver samples from June 2013 to December 2018. Donors and recipients' clinical characteristics, including follow-up data were retrieved. The graft and overall survival with/without steatosis or portal inflammation were compared by Kaplan-Meier analysis.

Results:

For living donors, the medium age of was 31.2 (28, 35.8) years old; liver histopathology showed macrovesicular steatosis: 0-5% 264/305 (86.6%) and 5-30% 41/305 (13.4%), IPI: no 220/305 (72.1%) and mild 85/305 (27.9%). For recipients, the medium age was 1.0 (0.6, 1.5) years old; the median pediatric-end-stage-liver-disease score was 16 (5.0, 26.0) and medium follow-up time was 32.8 (24.8, 52.0) months. Biliary atresia (69.5%) was the main indication for liver transplantation (LT).

Conclusions:

The presence of steatosis and portal inflammation of the donor liver did not impact the clinical outcomes including transaminase or bilirubin normalization, short-/long-term complications and recipients' survival. However, recipients with high pediatric-end-stage-liver-disease score (>16) receiving donor liver with portal inflammation, but not steatosis, had trend negative effect on recipients' survival. In conclusion, donor livers with mild steatosis and portal inflammation were qualified for pediatric living donor LT. However, donor liver with mild portal inflammation would better not be allocated to recipients with high pediatric-end-stage-liver-disease score. This study provided new evidence in pediatric living donor liver allocation.

• Authors: Xinyan Zhao, Yafei He, Jimin Liu, Qian Zhang, Liwei Liu, Wei Qu, Ying Liu, Zhigui Zeng, Haiming Zhang, Jidong Jia, Liying Sun, Lin Wei, Zhijun Zhu
• Journal: Hepatobiliary surgery and nutrition (Hepatobiliary Surg Nutr) Vol. 11 Issue 3 Pg. 340-354 (Jun 2022) ISSN: 2304-3881 [Print] China (Republic : 1949- )
• PMID: 35693402 (Publication Type: Journal Article)
• Copyright: 2022 Hepatobiliary Surgery and Nutrition. All rights reserved.