Liver Discard Rate Attributable to Conservative Estimations of Steatosis: An Inference-based Approach.

IF 5 2区医学 Q1 IMMUNOLOGY

Transplantation Pub Date : 2025-10-01 Epub Date: 2025-05-08 DOI:10.1097/TP.0000000000005401

Hao Guo, Boris L Gala-Lopez, Ian P J Alwayn, Kevin C Hewitt

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引用次数: 0

Abstract

Background: On-site conservative estimations of steatosis could result in the unnecessary discard of donor livers. This study applied the body mass index as an independent statistical indicator to determine the extent of this problem. We aimed to quantitatively evaluate if decisions based nonbiopsy donor liver assessments are more conservative (inclined to reject marginal fatty livers) than biopsy-based evaluations.

Methods: The study processed intradatabase comparisons using 177 081 datasets from Organ Procurement and Transplantation Network spanning 2004 to 2022 September in the United States. Postmatching body mass index was applied as an independent indicator of statistical risk of hepatic steatosis (HS).

Results: A total of 7420, 4990, 5994, and 7523 pair of donors with/without biopsy records were matched in 2004-2010, 2011-2014, 2015-2018, and 2019-2022 September, respectively. Consistent with our hypothesis, absent biopsies and evaluations before and during organ procurement were observed to be more conservative, leading to the discard of 16.4% (2004-2010), 16.9% (2011-2014), 10.6% (2015-2018), and 10.3% (2019-2022 September) of potential donor livers.

Conclusions: The study concludes that there was a significant (10.3%-16.9%) disparity caused by on-site nonbiopsy assessments of HS, leading to the unnecessary discard of potential donor livers. The findings emphasize the need to develop more accurate intraoperative techniques for assessing HS to optimize donor liver procurement.

查看原文本刊更多论文

肝脏丢弃率归因于脂肪变性的保守估计：一种基于推断的方法。

背景：现场保守估计脂肪变性可能导致供体肝脏不必要的丢弃。本研究采用身体质量指数作为独立统计指标来确定这一问题的严重程度。我们旨在定量评估基于非活检供体肝脏评估的决策是否比基于活检的评估更保守（倾向于拒绝边缘性脂肪肝）。方法：该研究对2004年至2022年9月期间来自美国器官获取和移植网络的177 081个数据集进行了数据库内比较。配对后体重指数作为肝脂肪变性（HS）统计风险的独立指标。结果：2004-2010年9月、2011-2014年9月、2015-2018年9月和2019-2022年9月，匹配有/无活检记录的献血者分别为7420对、4990对、5994对和7523对。与我们的假设一致，在器官获取之前和过程中没有活检和评估被观察到更为保守，导致16.4%（2004-2010）、16.9%（2011-2014）、10.6%（2015-2018）和10.3%（2019-2022年9月）的潜在供体肝脏被丢弃。结论：本研究认为，HS的现场非活检评估存在显著差异（10.3%-16.9%），导致潜在供肝的不必要丢弃。研究结果强调需要开发更准确的术中技术来评估HS，以优化供肝的获取。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation 医学-免疫学

CiteScore

8.50

自引率

11.30%

发文量

1906

审稿时长

1 months

期刊介绍： The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year. Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal. Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed. The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.