Clear mortality gap caused by graft macrosteatosis in Chinese patients after cadaveric liver transplantation  

作　　者：Zhengtao Liu Wenchao Wang Li Zhuang Jingfeng Liu Shuping Que Dan Zhu Linfang Dong Jian Yu Lin Zhou Shusen Zheng 

机构地区：[1]Division of Hepatobiliary and Pancreatic Surgery,Department of Surgery,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China [2]NHC Key Laboratory of Combined Multi-Organ Transplantation,Key Laboratory of the Diagnosis and Treatment of Organ Transplantation,CAMS,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China [3]Key Laboratory of Organ Transplantation of Zhejiang Province,First Affiliated Hospital,School of Medicine,Zhejiang University,Hangzhou,China [4]Shulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College,Hangzhou,China [5]Science for Life Laboratory,KTH-Royal Institute of Technology,SE-17121,Stockholm,Sweden [6]Dingxiang Clinics,Hangzhou,China

出　　处：《Hepatobiliary Surgery and Nutrition》2020年第6期739-758,共20页肝胆外科与营养（英文）

基　　金：This study is supported by Innovative Research Groups of National Natural Science Foundation of China(81721091);Major program of National Natural Science Foundation of China(91542205);National S&T Major Project(2017ZX10203205);National Natural Science Foundation of China(81902813);Zhejiang International Science and Technology Cooperation Project(2016C04003);Zhejiang Provincial Natural Science Foundation of China(LY18H030002);Zhejiang Medical Association(2019ZYC-A81);International Youth Exchange Programme by China Association for Science and Technology(2019);Tianqing Liver Diseases Research Fund(TQGB20200114);Open Fund of Key laboratory of High-Incidence-Tumor Prevention&Treatment(Guangxi Medical University),Ministry of Education.

摘　　要：Background:Liver transplantation(LT)is one of the most effective surgical treatment for patients with end-stage liver disease.Steatosis is a contributor for inferior graft quality.But its impact and safety on transplantation was less assessed in Chinese patients.Methods:Graft steatosis and related information involved in recipients,donors and surgical procedures were retrospectively collected from 239 patients.Results:Donor macrosteatosis(MaS)caused about 2.14 and 2.80 folds of increment on patient and graft mortality.Dose-response analysis revealed prominent risk of grafts on overall patient/organ mortality when MaS content exceeded 10%(P<0.05).Noteworthy,deaths were only observed in MaS group when concurrent with extremely higher post-transplant alanine aminotransferase(ALT,64%).However,microsteatosis(MiS)grafts didn’t affect outcomes after LT.In a cohort of Chinese patients,MaS had comprehensive effects on post-transplant outcomes with relatively lower safety threshold at 10%.Mortality gap caused by MaS grafts was observed in patients with severer ischemia reperfusion injury.Conclusions:Our study revealled the graft MaS affected the post-transplant outcomes in lower risk cutoff in Chinese patients.Further study is worthy to validate these results and investigate inner mechanism under the phenomenon.

关 键 词：STEATOSIS prognosis liver transplantation(LT) dose-response analysis 

分 类 号：R57[医药卫生—消化系统]