Ben L Da, Jinendra Satiya, Rajiv P Heda, Yu Jiang, Lawrence F Lau, Ahmed Fahmy, Aaron Winnick, Nitzan Roth, Elliot Grodstein, Paul J Thuluvath, Ashwani K Singal, Thomas D Schiano, Lewis W Teperman, Sanjaya K Satapathy
{"title":"脂肪变性肝移植后的结果:重新定义脂肪变性肝移植的可接受临界值。","authors":"Ben L Da, Jinendra Satiya, Rajiv P Heda, Yu Jiang, Lawrence F Lau, Ahmed Fahmy, Aaron Winnick, Nitzan Roth, Elliot Grodstein, Paul J Thuluvath, Ashwani K Singal, Thomas D Schiano, Lewis W Teperman, Sanjaya K Satapathy","doi":"10.5005/jp-journals-10018-1361","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Graft macrosteatosis can predispose to a higher risk of graft loss so we sought to redefine acceptable cutoffs for graft steatosis.</p><p><strong>Methods: </strong>Data of 26,103 donors who underwent liver transplantation (LT) between January 2004 and December 2018 from the UNOS-STAR database were utilized. A high-risk steatotic (HRS) graft and a low-risk steatotic (LRS) graft were defined as ≥20% and <20% macrosteatosis, respectively. High-risk steatotic grafts were further classified as grafts with 20-29% (G1S grafts), 30-39% (G2S grafts), and ≥40% steatosis (G3S grafts). Outcomes between groups were compared.</p><p><strong>Results: </strong>LRS grafts had excellent graft (93.3 and 87.7%) and overall survival (95.4 and 90.5%) at 90 days and 1 year. Compared to LRS grafts, G1S, G2S, and G3S grafts had worse graft and overall survival at 90 days and 1-year (<i>p</i> <0.001). There was no difference in graft or overall survival of G1S or G3S grafts compared to G2S grafts until after adjustment in which G3S grafts were found to be associated with an increased risk of graft loss-aHR 1.27 (1.03-1.57), <i>p</i> = 0.02.</p><p><strong>Discussion: </strong>Liver grafts can be categorized into three categories: (1) <20% or \"very low risk\", (2) 20-39% or \"low-to-moderate risk\", and usually acceptable, and (3) ≥40% steatosis or \"moderate-to-high risk\".</p><p><strong>How to cite this article: </strong>Da BL, Satiya J, Heda RP, <i>et al</i>. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S5-S14.</p>","PeriodicalId":11992,"journal":{"name":"Euroasian Journal of Hepato-Gastroenterology","volume":"12 Suppl 1","pages":"S5-S14"},"PeriodicalIF":0.0000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/00/ejohg-12-s5.PMC9681573.pdf","citationCount":"0","resultStr":"{\"title\":\"Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts.\",\"authors\":\"Ben L Da, Jinendra Satiya, Rajiv P Heda, Yu Jiang, Lawrence F Lau, Ahmed Fahmy, Aaron Winnick, Nitzan Roth, Elliot Grodstein, Paul J Thuluvath, Ashwani K Singal, Thomas D Schiano, Lewis W Teperman, Sanjaya K Satapathy\",\"doi\":\"10.5005/jp-journals-10018-1361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Graft macrosteatosis can predispose to a higher risk of graft loss so we sought to redefine acceptable cutoffs for graft steatosis.</p><p><strong>Methods: </strong>Data of 26,103 donors who underwent liver transplantation (LT) between January 2004 and December 2018 from the UNOS-STAR database were utilized. A high-risk steatotic (HRS) graft and a low-risk steatotic (LRS) graft were defined as ≥20% and <20% macrosteatosis, respectively. High-risk steatotic grafts were further classified as grafts with 20-29% (G1S grafts), 30-39% (G2S grafts), and ≥40% steatosis (G3S grafts). Outcomes between groups were compared.</p><p><strong>Results: </strong>LRS grafts had excellent graft (93.3 and 87.7%) and overall survival (95.4 and 90.5%) at 90 days and 1 year. Compared to LRS grafts, G1S, G2S, and G3S grafts had worse graft and overall survival at 90 days and 1-year (<i>p</i> <0.001). There was no difference in graft or overall survival of G1S or G3S grafts compared to G2S grafts until after adjustment in which G3S grafts were found to be associated with an increased risk of graft loss-aHR 1.27 (1.03-1.57), <i>p</i> = 0.02.</p><p><strong>Discussion: </strong>Liver grafts can be categorized into three categories: (1) <20% or \\\"very low risk\\\", (2) 20-39% or \\\"low-to-moderate risk\\\", and usually acceptable, and (3) ≥40% steatosis or \\\"moderate-to-high risk\\\".</p><p><strong>How to cite this article: </strong>Da BL, Satiya J, Heda RP, <i>et al</i>. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. 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引用次数: 0
摘要
背景:移植物大脂肪变性可导致更高的移植物损失风险，因此我们试图重新定义移植物脂肪变性的可接受临界值。方法:利用UNOS-STAR数据库中2004年1月至2018年12月期间接受肝移植(LT)的26103例供体的数据。高风险脂肪变性(HRS)移植物和低风险脂肪变性(LRS)移植物的定义为≥20%。结果:LRS移植物在90天和1年的总生存率(93.3%和87.7%)和总生存率(95.4和90.5%)优异。与LRS移植相比，G1S、G2S和G3S移植在90天和1年的移植和总生存率较差(p p = 0.02)。讨论:肝移植可分为三类:(1)文章引用方式:Da BL, Satiya J, Heda RP, et al。脂肪变性肝移植后的结果:重新定义脂肪变性肝移植的可接受临界值。中华肝病与胃肠病杂志，2012;12(增刊1):559 - 564。
Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts.
Background: Graft macrosteatosis can predispose to a higher risk of graft loss so we sought to redefine acceptable cutoffs for graft steatosis.
Methods: Data of 26,103 donors who underwent liver transplantation (LT) between January 2004 and December 2018 from the UNOS-STAR database were utilized. A high-risk steatotic (HRS) graft and a low-risk steatotic (LRS) graft were defined as ≥20% and <20% macrosteatosis, respectively. High-risk steatotic grafts were further classified as grafts with 20-29% (G1S grafts), 30-39% (G2S grafts), and ≥40% steatosis (G3S grafts). Outcomes between groups were compared.
Results: LRS grafts had excellent graft (93.3 and 87.7%) and overall survival (95.4 and 90.5%) at 90 days and 1 year. Compared to LRS grafts, G1S, G2S, and G3S grafts had worse graft and overall survival at 90 days and 1-year (p <0.001). There was no difference in graft or overall survival of G1S or G3S grafts compared to G2S grafts until after adjustment in which G3S grafts were found to be associated with an increased risk of graft loss-aHR 1.27 (1.03-1.57), p = 0.02.
Discussion: Liver grafts can be categorized into three categories: (1) <20% or "very low risk", (2) 20-39% or "low-to-moderate risk", and usually acceptable, and (3) ≥40% steatosis or "moderate-to-high risk".
How to cite this article: Da BL, Satiya J, Heda RP, et al. Outcomes after Liver Transplantation with Steatotic Grafts: Redefining Acceptable Cutoffs for Steatotic Grafts. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S5-S14.
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