Riva G, Villanova M, Cima L, Ghimenton C, Bronzoni C, Colombari R, Crestani M, Sina S, Brunelli M, D'Errico A, Montin U, Novelli L, Eccher A
Department of Diagnostics and Public Health, Section of Pathology, University of Verona, Verona, Italy.
Liver Transplant Unit, Department of Surgical Science, University and Hospital Trust of Verona, Verona, Italy.
Transplant Proc. 2018 Dec;50(10):3539-3543. doi: 10.1016/j.transproceed.2018.06.013. Epub 2018 Jun 22.
Oil Red O is a useful tool to assess donor liver steatosis on frozen sections during transplantation. Steatosis is a frequent finding in liver evaluation during transplantation, accounting for 9% to 26% of biopsied donor liver. The degree of macrovesicular steatosis is classified as mild, moderate, and severe; the latter is considered an absolute contraindication to liver transplantation because it is associated with poor allograft outcome. Because of the scarcity of organs, there is a debate whether livers with less severe macrovesicular steatosis are still suitable for transplant. Consequently, tools or methods that allow a more accurate intraoperative assessment of steatosis on frozen sections are mandatory. The aim of this study is to improve intraoperative evaluation of steatosis during transplantation using Oil Red O stain on liver biopsies.
Twenty consecutive liver biopsies of donors were collected during transplantation procedures from September 2017 to February 2018 at the Institute of Pathology of the University and Hospital Trust of Verona, Italy. Each liver biopsy was cut at a different thickness (3, 5, and 8 μm) and stained with both Oil Red O and conventional hematoxylin and eosin for intraoperative consultation. The degree (percentage of hepatocytes involved) of fatty changes was recorded. The results obtained during the intraoperative consultation were finally compared with the formalin-fixed and paraffin-embedded permanent section.
Assessment of steatosis on hematoxylin and eosin frozen sections was reported as mild in 17 cases (85%), moderate in 2 cases (10%) and severe in 1 case (5%). Oil Red O frozen sections reported the following results: mild steatosis in 16 cases (80%), moderate in 2 cases (10%), and severe in 2 cases (10%). The percentage of liver steatosis obtained with Oil Red O was consistent in all cases with that of the permanent sections. The staining procedure for Oil Red O required approximately 18 minutes.
Oil Red O special stain is a fast and inexpensive tool to improve the assessment of steatosis on frozen biopsies during liver transplantation.
油红O是在移植过程中评估冷冻切片上供体肝脏脂肪变性的有用工具。脂肪变性是移植肝脏评估中常见的发现，占活检供体肝脏的9%至26%。大泡性脂肪变性程度分为轻度、中度和重度；后者被认为是肝移植的绝对禁忌证，因为它与移植肝预后不良有关。由于器官稀缺，对于大泡性脂肪变性程度较轻的肝脏是否仍适合移植存在争议。因此，必须有能够在术中更准确评估冷冻切片脂肪变性的工具或方法。本研究的目的是通过对肝活检进行油红O染色来改进移植过程中脂肪变性的术中评估。
2017年9月至2018年2月在意大利维罗纳大学医院信托病理研究所的移植手术过程中，连续收集了20例供体肝脏活检样本。将每例肝脏活检样本切成不同厚度（3、5和8μm），并用油红O和传统苏木精-伊红染色用于术中会诊。记录脂肪变程度（受累肝细胞百分比）。将术中会诊获得的结果最终与福尔马林固定石蜡包埋的永久切片进行比较。
苏木精-伊红冷冻切片上脂肪变性评估为轻度17例（85%），中度2例（10%），重度1例（5%）。油红O冷冻切片结果如下：轻度脂肪变性16例（80%），中度2例（10%），重度2例（10%）。油红O检测得到的肝脏脂肪变性百分比在所有病例中与永久切片一致。油红O染色过程大约需要18分钟。
油红O特殊染色是一种快速且廉价的工具，可用于改进肝移植术中冷冻活检脂肪变性的评估。
