News From Transplant Week of June 16, 2002 / Vol. 3 No. 24

 

Survey: U.S. Surgeons More Conservative in Accepting Livers for Transplant
 

 

American surgeons generally are more conservative about not using fatty donor livers for transplants than their British counterparts, according to a survey published in the journal Liver Transplantation.

The issue is of considerable importance, because steatosis -- fatty change in the liver in the liver that can lead to fibrosis (inflammation) and cirrhosis (scarring) -- is strongly associated with development of liver nonfunction in transplant recipients.

University of Oxford researchers, who surveyed liver transplant surgeons in both the United Kingdom and United States, reported that appraisal of donor livers remains "one of the least scientific aspects of the transplantation process."

"We found that current practice policies differ not only between nations, but also among centers in each country," the researchers reported.

With far too few cadaver livers available for transplantation into the growing number of patients on waiting lists for this life-saving surgery, the researchers reported sharp differences of opinion among transplant doctors on the significance of steatosis.

"The appetite for fatty livers is different for each transplant surgeon," they reported. "Many centers base their practice on subjective opinion, rather than objective data."

Nevertheless, they said "U.S. surgeons generally follow a more conservative approach, with greater emphasis on histological assessment."

Other sources: Liver Transplantation