Inserm, Unité 1193, Villejuif, France; Université Paris Saclay, Institut André Lwoff, Villejuif, France; AP-HP Hôpital Paul Brousse, Centre Hépatobiliaire, Villejuif, France.
Université Paris Saclay, Institut André Lwoff, Villejuif, France; Inserm, US33, Villejuif, France.
Lab Invest. 2024 Sep;104(9):102110. doi: 10.1016/j.labinv.2024.102110. Epub 2024 Jul 14.
Liver transplantation (LT) is a major treatment for patients with end-stage liver diseases. Steatosis is a significant risk factor for primary graft nonfunction and associated with poor long-term graft outcomes. Traditionally, the evaluation of steatosis is based on frozen section examination to estimate the percentage of hepatocytes containing lipid vesicles. However, this visual evaluation correlates poorly with the true lipid content. This study aimed to address the potential of infrared (IR) microspectroscopy for rapidly estimating lipid content in the context of LT and assessing its impact on survival. Clinical data were collected for >20 months from 58 patients who underwent transplantation. For each liver graft, macrovacuolar steatosis and microvesicular steatosis were evaluated through histologic examination of frozen tissue section. Triglycerides (TG) were further quantified using gas phase chromatography coupled with a flame ionization detector (GC-FID) and estimated by IR microspectroscopy. A linear relationship and significant correlation were observed between the TG measured by GC-FID and those estimated using IR microspectroscopy (R = 0.86). In some cases, microvesicular steatosis was related to high lipid content despite low levels of macrovacuolar steatosis. Seven patients experienced posttransplantation liver failure, including 5 deceased patients. All patients underwent transplantation with grafts containing significantly high TG levels. A concentration of 250 nmol/mg was identified as the threshold above which the risk of failure after LT significantly increased, affecting 35% of patients. Our study established a strong correlation between LT outcomes and lipid content. IR microspectroscopy proved to be a rapid and reliable approach for assessing the lipid content in clinical settings.
肝移植（LT）是治疗终末期肝病患者的主要手段。脂肪变性是原发性移植物无功能的重要危险因素，并与不良的长期移植物结局相关。传统上，脂肪变性的评估基于冰冻切片检查来估计含有脂质泡的肝细胞的百分比。然而，这种视觉评估与真实的脂质含量相关性较差。本研究旨在探讨红外（IR）显微光谱法在 LT 中快速估计脂质含量的潜力，并评估其对存活率的影响。从接受移植的 58 名患者中收集了超过 20 个月的临床数据。对于每个肝移植物，通过对冰冻组织切片进行组织学检查评估大泡性脂肪变性和微泡性脂肪变性。使用气相色谱法结合火焰电离检测器（GC-FID）进一步定量甘油三酯（TG），并通过 IR 显微光谱法进行估计。通过 GC-FID 测量的 TG 与通过 IR 显微光谱法估计的 TG 之间存在线性关系和显著相关性（R=0.86）。在某些情况下，尽管大泡性脂肪变性水平较低，但微泡性脂肪变性与高脂质含量相关。7 名患者经历了移植后肝衰竭，包括 5 名死亡患者。所有患者均接受了含有明显高 TG 水平的移植物移植。当 TG 浓度达到 250 nmol/mg 时，LT 后失败的风险显著增加，影响了 35%的患者，这被确定为一个阈值。我们的研究确立了 LT 结果与脂质含量之间的强相关性。IR 显微光谱法被证明是一种快速可靠的方法，可用于评估临床环境中的脂质含量。
