Hepatic macrosteatosis in the US pediatric deceased liver donor population.
Hepatic macrosteatosis in the US pediatric deceased liver donor population.
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DOI：
10.1111/petr.14155
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发表时间：
2022-03
影响因子：
1.3
通讯作者：
Locke JE
中科院分区：
文献类型：
--
作者：
Purvis JW;Orandi BJ;Dhall D;McLeod C;Gutierrez Sanchez LH;Gray M;Frey K;Sheikh SS;Cannon RM;Terrault NA;Lewis CE;Locke JE
The pediatric obesity epidemic is associated with early development of hepatic macrosteatosis, a hallmark of nonalcoholic fatty liver disease, which is thought to be more rapidly progressive in children than adults. Macrosteatosis in adult allografts is associated with allograft loss, but this has not been examined in pediatric donors. We studied all pediatric potential whole liver donors (2005–2018) who had a liver biopsy in the Scientific Registry for Transplant Recipients (SRTR) (n=862) and whose liver was transplanted (n=862). Macrosteatosis was abstracted from biopsy reports and compared to values in the SRTR standard analytic file. Recipients of macrosteatotic pediatric allografts were matched 1:1 to recipients of non-macrosteatotic pediatric allografts by propensity score matching on donor/recipient variables. All-cause allograft loss was estimated via Kaplan-Meier analysis and Cox proportional hazards model. From 2005–2018, the proportion of pediatric donors (age≥2 years) with obesity increased (14.8% to 21.7%; P<0.001), as did the proportion of pediatric deceased whole liver-only donor allografts with macrosteatosis (n=10,648; 1.8% to 3.9%; P<0.001). The median degree of macrosteatosis among macrosteatotic donors was 10% (IQR 5–30). There were no significant differences in all-cause allograft loss between recipients of pediatric liver allografts with and without macrosteatosis at 90 days (P=0.11) or 1 year (P=0.14) post-transplant in Kaplan-Meier analysis or a Cox proportional hazards model (P>0.05). Obese pediatric liver donors have increased over time and were more likely to have hepatic macrosteatosis; however, pediatric macrosteatosis did not appear to adversely affect recipient outcomes.
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