Hepatobiliary Surgery and Liver Transplant Unit, Hospital Aleman of Buenos Aires, Buenos Aires, Argentina.
J Hepatol. 2011 May;54(5):1055-62. doi: 10.1016/j.jhep.2010.11.004. Epub 2010 Nov 13.
Steatotic liver grafts represent the most common type of "extended criteria" organs that have been introduced during the last two decades due to the disparity between liver transplant candidates and the number available organs. A precise definition and reliable and reproducible method for steatosis quantification is currently lacking and the potential influence of the chemical composition of hepatic lipids has not been addressed. In our view, these shortcomings appear to contribute significantly to the inconsistent results of studies reporting on graft steatosis and the outcome of liver transplantation. In this review, various definitions, prevalence and methods of quantification of liver steatosis will be covered. Ischemia/reperfusion injury of the steatotic liver and its consequences on post-transplant outcome will be discussed. Selection criteria for organ allocation and a number of emerging protective strategies are suggested.
脂肪肝供肝是过去 20 年中引入的最常见的“扩展标准”器官类型，这是由于肝移植候选者和可用器官数量之间存在差异所致。目前缺乏对肝脂肪化学组成物潜在影响的明确定义以及可靠和可重复的脂肪变性定量方法。在我们看来，这些缺陷似乎是导致报道供体脂肪变性和肝移植结果的研究结果不一致的重要原因。在这篇综述中，将涵盖各种肝脂肪变性的定义、流行程度和定量方法。还将讨论脂肪肝的缺血/再灌注损伤及其对移植后结果的影响。提出了器官分配的选择标准和一些新兴的保护策略。
