A biopsy from a donor liver may be submitted for frozen section prior to transplantation. This can help identify and reject livers that could function poorly after the transplant.
Parameters:
(1) steatosis
(2) liver cell (hepatocellular) necrosis
(3) evidence of alcohol-induced injury
(4) hepatitis
|
Parameter |
Finding |
Disposition of Donor Liver |
|
macrosteatosis |
mild (< 30%) |
use |
|
|
moderate (30 - 60%) |
uncertain |
|
|
marked (> 60%) |
reject |
|
hepatocellular necrosis |
minimal |
use |
|
|
mild |
uncertain |
|
|
moderate or severe |
reject |
|
alcohol induced injury |
minimal |
use |
|
|
mild |
uncertain |
|
|
moderate or severe |
reject |
|
hepatitis |
minimal |
use |
|
|
mild |
uncertain |
|
|
moderate or severe |
reject |
where:
• Microvesicular steatosis is not as significant as macrovesicular steatosis.
• Livers from patients with alcohol abuse tend to show functional deterioration months after the transplant.
A liver with a single uncertain factor can be used if all of the other findings are normal.
Permanent sections of the transplant liver are important to serve as the baseline for comparison of later, post-transplant biopsies.
Specialty: Gastroenterology, Surgery, general
ICD-10: ,
