{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:18:29Z","timestamp":1778815109376,"version":"3.51.4"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:p>The number of steatotic deceased donor livers encountered has continued to rise as a result of the obesity epidemic. Little is known about the histological characteristics of moderately macrosteatotic livers over time in the recipient following liver transplantation (LT). All recipients undergoing LT at Mayo Clinic Florida with donor livers with moderate macrosteatosis (30%\u201060%) from 2000\u20102017 were identified (n = 96). Routine protocol liver biopsies were performed 1\u2010week and 6\u2010months following LT. All liver donor and protocol biopsies were read by an experienced liver pathologist. Of the 96 moderate macrosteatosis LTs, 70 recipients had post\u2010LT protocol liver biopsies available and comprised the study cohort. Median donor allograft macrosteatosis at the time of transplant was 33% (IQR, 30%\u201040%) compared with 0% (IQR, 0%\u20102%) at 1\u2010week (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) and 0% (IQR, 0%\u20100%) at 6\u2010months (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) following LT. Biopsies at 1\u2010week post\u2010LT displayed pericentral necrosis in 57.1% of recipients and lipopeliosis in 34.3% of recipients. In the 6\u2010month post\u2010LT biopsies, cholestasis was seen in 3 (4.3%) of the recipients, whereas grade 2 fibrosis was seen in 6 recipients (8.6%). Graft survival at 5 years in the present cohort was 74.0%. Moderate macrosteatosis (30%\u201060%) in the donor allograft demonstrates complete reversal on liver biopsies performed as early as 7 days following LT and remains absent at 6\u2010months following LT. Both pericentral necrosis and lipopeliosis are common features on day 7 biopsies. Despite these encouraging findings, the perioperative risks of using these livers (postreperfusion cardiac arrest and primary nonfunction) should not be understated. Long\u2010term graft survival is acceptable in patients who are able to overcome the immediate perioperative risk of using moderately steatotic donor livers.<\/jats:p>","DOI":"10.1002\/lt.25867","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T19:45:04Z","timestamp":1597175104000},"page":"248-256","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Sequential Protocol Biopsies Post\u2013Liver Transplant From Donors With Moderate Macrosteatosis: What Happens to the Fat?"],"prefix":"10.1097","volume":"27","author":[{"given":"Kristopher P.","family":"Croome","sequence":"first","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Livingston","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Croome","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew P.","family":"Keaveny","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Burcin","family":"Taner","sequence":"additional","affiliation":[{"name":"Department of Transplant,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raouf","family":"Nakhleh","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology,Mayo Clinic Florida,Jacksonville,FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"key":"lt25867-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1001\/jama.2012.39","article-title":"Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999\u20102010","volume":"307","year":"2012","journal-title":"JAMA"},{"key":"lt25867-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"610","DOI":"10.7150\/ijbs.29599","article-title":"Obesity, nonalcoholic fatty liver disease and adipocytokines network in promotion of cancer","volume":"15","year":"2019","journal-title":"Int J Biol Sci"},{"key":"lt25867-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/j.1432-2277.2005.00091.x","article-title":"Assignment of steatotic livers by the Mayo model for end\u2010stage liver disease","volume":"18","year":"2005","journal-title":"Transpl Int"},{"key":"lt25867-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1440-1746.2011.06844.x","article-title":"Grade of deceased donor liver macrovesicular steatosis impacts graft and recipient outcomes more than the Donor Risk Index","volume":"27","year":"2012","journal-title":"J Gastroenterol Hepatol"},{"key":"lt25867-bib-0007-20250824","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S1499-3872(17)60064-X","article-title":"Grade of donor liver microvesicular steatosis does not affect the postoperative outcome after liver transplantation","volume":"16","year":"2017","journal-title":"Hepatobiliary Pancreat Dis Int"},{"key":"lt25867-bib-0008-20250824","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.1111\/ajt.15330","article-title":"The impact of postreperfusion syndrome during liver transplantation using livers with significant macrosteatosis","volume":"19","year":"2019","journal-title":"Am J Transplant"},{"key":"lt25867-bib-0009-20250824","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/00007890-199101000-00024","article-title":"The predictive value of donor liver biopsies for the development of primary nonfunction after orthotopic liver transplantation","volume":"51","year":"1991","journal-title":"Transplantation"},{"key":"lt25867-bib-0010-20250824","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1053\/jlts.2002.31747","article-title":"Current practice regarding the use of fatty livers: atrans\u2010Atlantic survey","volume":"8","year":"2002","journal-title":"Liver Transpl"},{"key":"lt25867-bib-0012-20250824","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/lt.25408","article-title":"The \u201cSkinny\u201d on assessment and utilization of steatotic liver grafts: a systematic review","volume":"25","year":"2019","journal-title":"Liver Transpl"},{"key":"lt25867-bib-0013-20250824","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1097\/00007890-199304000-00024","article-title":"Risk factors for primary dysfunction after liver transplantation a multivariate analysis","volume":"55","year":"1993","journal-title":"Transplantation"},{"key":"lt25867-bib-0014-20250824","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1002\/lt.25583","article-title":"Does donor allograft microsteatosis matter? 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