The acceptable threshold remains unknown for the percentage of macrosteatosis (MaS) and microsteatosis (MiS) to yield optimal outcomes after donation after circulatory death (DCD) liver transplantation (LT). The purpose of this analysis was to determine the impact of donor liver MaS and MiS on DCD LT outcomes. Using the Organ Procurement and Transplantation Network database, we analyzed pretransplant biopsy results from adult, solitary, DCD livers transplanted between January 1, 2006, and December 31, 2017. Kaplan‐Meier analysis was used to assess graft and patient survival based on MaS and MiS severity. MiS was divided into the groups MiS ≤10% and >10%. MaS was divided into the groups MaS ≤15% and >15%. Of 7757 recovered DCD livers, 11.4% (n = 885) were biopsied and transplanted. Patients who received DCD livers with MaS >15% had significantly worse patient survival (P < 0.04), and those with MiS >10% demonstrated inferior graft and patient survival (P < 0.02). In multivariate analyses including known risk factors, both MaS >15% and MiS >10% were associated with increased risk of graft failure and patient mortality (P < 0.03). Recipient and donor age >60 years were also associated with increased risk of graft failure and patient death. This analysis demonstrates that MaS >15% and MiS >10% are additional risk factors for graft loss and patient mortality in DCD LT.

中文翻译：

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循环性死亡供体后肝脏中的微脂肪变性与肝移植后的不良结果有关。

对于在循环死亡 (DCD) 肝移植 (LT) 后捐献后产生最佳结果的大脂肪变性 (MaS) 和微脂肪变性 (MiS) 的百分比，可接受的阈值仍然未知。该分析的目的是确定供肝 MaS 和 MiS 对 DCD LT 结果的影响。使用器官采购和移植网络数据库，我们分析了 2006 年 1 月 1 日至 2017 年 12 月 31 日期间移植的成人、单发、DCD 肝脏的移植前活检结果。Kaplan-Meier 分析用于基于 MaS 和MiS 严重性。MiS 分为 MiS ≤10% 和 >10% 组。MaS 分为 MaS ≤15% 和 >15% 组。在 7757 个恢复的 DCD 肝脏中，11.4% (n = 885) 进行了活检和移植。接受 DCD 肝脏的 MaS 患者 >P  < 0.04），MiS > 10% 的移植物和患者存活率较差（P  < 0.02）。在包括已知风险因素的多变量分析中，MaS >15% 和 MiS >10% 都与移植失败风险和患者死亡率增加相关（P  < 0.03）。接受者和捐赠者年龄>60 岁也与移植失败和患者死亡的风险增加有关。该分析表明，MaS >15% 和 MiS >10% 是 DCD LT 中移植物丢失和患者死亡率的额外风险因素。