Assessment of hepatic steatosis by transplant surgeon and expert pathologist: A prospective, double-blind evaluation of 201 donor livers

• DOI: 10.1002/lt.23615
• Publication Date: 2013-02-13T18:11:34Z
• Authors: Hasan Yersiz; Coney Lee; Fady M. Kaldas; Johnny C. Hong; Abbas Rana; Gabriel T. Schnickel; Jason A. Wertheim; Ali Zarrinpar; Vatche G. Agopian; Jeffrey Gornbein; Bita V. Naini; Charles R. Lassman; Ronald W. Busuttil; Henrik Petrowsky
• Keywords: Steatosis; Gold standard (test); Grading (engineering)

An accurate clinical assessment of hepatic steatosis before transplantation is critical for successful outcomes after liver transplantation, especially if a pathologist not available at the time procurement. This prospective study investigated surgeon's accuracy in predicting and organ quality 201 adult donor livers. A by blinded expert served as reference gold standard. The estimate correlated more strongly with large-droplet macrovesicular [ld-MaS; nonparametric Spearman correlation coefficient (rS ) = 0.504] versus small-droplet (sd-MaS; rS 0.398). True microvesicular was present only 2 donors (1%). Liver texture criteria (yellowness, absence scratch marks, round edges) were mainly associated ld-MaS (variance 0.619) less sd-MaS 0.264). prediction ≥30% <30% excellent when used (accuracy 86.2%), but it direct estimation percentage 75.5%). grading degree well incidence poor initial function primary nonfunction. In conclusion, precise remains challenging even experienced hands. characteristics are helpful identifying macrosteatotic organs than actual perception steatosis. These findings important histological donor's hospital.