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Purvis JW, Orandi BJ, Dhall D, et al. Hepatic macrosteatosis in the US pediatric deceased liver donor population. Pediatr Transplant. 2021;e14155doi: 10.1111/petr.14155.
Purvis, J. W., Orandi, B. J., Dhall, D., McLeod, C., Gutierrez Sanchez, L. H., Gray, M., Frey, K., Sheikh, S. S., Cannon, R. M., Terrault, N. A., Lewis, C. E., & Locke, J. E. (2021). Hepatic macrosteatosis in the US pediatric deceased liver donor population. Pediatric transplantation, e14155. https://doi.org/10.1111/petr.14155
Purvis, Joshua W, et al. "Hepatic macrosteatosis in the US pediatric deceased liver donor population." Pediatric transplantation vol. (2021): e14155. doi: https://doi.org/10.1111/petr.14155
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. Hepatic macrosteatosis in the US pediatric deceased liver donor population. Pediatr Transplant. 2021 Sep 30;e14155. doi: 10.1111/petr.14155. Epub 2021 Sep 30. PMID: 34590386.
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Pediatr Transplant. 2021 Sep 30;e14155. doi: 10.1111/petr.14155. Epub 2021 Sep 30.

Hepatic macrosteatosis in the US pediatric deceased liver donor population.

Pediatric transplantation

Joshua W Purvis, Babak J Orandi, Deepti Dhall, Chandler McLeod, Luz Helena Gutierrez Sanchez, Meagan Gray, Kayla Frey, Saulat S Sheikh, Robert M Cannon, Norah A Terrault, Cora E Lewis, Jayme E Locke

Affiliations

  1. Division of Transplantation, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  2. Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  3. Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  4. Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  5. Division of Gastrointestinal and Liver Diseases, Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
  6. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.

PMID: 34590386 DOI: 10.1111/petr.14155

Abstract

INTRODUCTION: The pediatric obesity epidemic is associated with early development of hepatic macrosteatosis, a hallmark of non-alcoholic fatty LI 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.

METHODS: We studied all pediatric potential whole LI donors (2005-2018) who had a LI biopsy in the SRTR (n = 862) and whose LI 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.

RESULTS: From 2005 to 2018, the proportion of pediatric donors (age ≥2 years) with obesity increased (14.8% to 21.7%; p < .001), as did the proportion of pediatric deceased whole LI-only donor allografts with macrosteatosis (n = 10 648; 1.8% to 3.9%; p < .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 LI allografts with and without macrosteatosis at 90 days (p = .11) or 1 year (p = .14) post-transplant in Kaplan-Meier analysis or a Cox proportional hazards model (p > .05).

CONCLUSION: Obese pediatric LI donors have increased over time and were more likely to have hepatic macrosteatosis; however, pediatric macrosteatosis did not appear to adversely affect recipient outcomes.

© 2021 Wiley Periodicals LLC.

Keywords: LI biopsy; macrosteatosis; obesity; pediatric liver transplant

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