Experimental study of the steatotic donor liver transplantation in rats / 第三军医大学学报

ABSTRACT

Objective To explore the effect of fatty liver on graft survival, especially with reference to macrovesicular and microvesicular steatosis and to evaluate the relationship between histological grading and inflammation activity. Methods Different degrees of rat fatty liver model were established by feeding rats a diet consisting of 79% standard diet, 20% lard and 1% cholesterol. By modified two cuff vascular anastomoses and end to end suture for bile duct, rat orthotopic liver transplantation was performed to evaluate the relationship between donor histological grading and survival rate. Results Low survival rate of macrosteatosis (grade Ⅲ) was found. Most rats died of liver failure in early days after transplantation. Pathological findings showed frequent hepatic necrosis. There was no significant difference between macrosteatosia(gradeⅠ) and the normal group. After transplantation, almost all of the fat was cleared by the end of the fourth week. Diminished steatosis and liver regeneration were found in macrosteatosis (gradeⅡ), while microsteatotic donors had higher survival rate than the other groups except the normal group. Conclusion Macrovesicular steatosis(grade Ⅲ) affects graft survival and these steatotic livers should not be used as donors. However, steatotic livers with mild macrovesicular steatosis (grade Ⅰ) and microvesicular steatosis(grade Ⅲ) do not influence recipient survival, so these livers can be used safely for liver transplantation. The ischemic damage should be considered when using livers of macrovesicular steatosis(gradeⅡ). Donors with numbering score more than 2.7 are correlated with the poor survival.