Evidence map›Paper›PMID 33931249›Full record

ArticleTransplantation proceedings2021

Moderately Macrosteatotic Livers Have Acceptable Long-Term Outcomes but Higher Risk of Immediate Mortality.

Jurgis Alvikas, Andrew-Paul Deeb, Dana R Jorgensen, Marta I Minervini, Anthony J Demetris, Kristina Lemon, Xilin Chen, Hanna Labiner, Shahid Malik, Christopher Hughes and 2 more

Open access · greenAbstract read
In one paragraph

Article in Transplantation proceedings, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Pediatric liver transplant outcomes: A comparative analysis of steatotic donor grafts.Journal of pediatric gastroenterology and nutrition · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Jurgis AlvikasDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: alvikasj2@upmc.edu.
Andrew-Paul DeebDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Dana R JorgensenDivision of Abdominal Transplantation Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Marta I MinerviniDivision of Liver and Transplant Pathology, Department of Anatomic Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Anthony J DemetrisDivision of Liver and Transplant Pathology, Department of Anatomic Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Kristina LemonDivision of Abdominal Transplantation Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Xilin ChenDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Hanna LabinerSchool of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Shahid MalikDivision of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Christopher HughesDivision of Abdominal Transplantation Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Abhinav HumarDivision of Abdominal Transplantation Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Amit TevarDivision of Abdominal Transplantation Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
University of Pittsburgh Medical Center · USUniversity of Pittsburgh · US

Funding

The role of platelet-specific NLRP3 inflammasome in venous thrombosis after traumaF32HL149207 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ALVIKAS, JURGIS · 2019 to 2020
$127k
NHLBI NIH HHS F32 HL149207Wellcome Trust
6 · The paper itself

Abstract

BACKGROUND AND

aimsLiver transplantation is the most effective treatment for end-stage liver disease (ESLD). Whether moderately macrosteatotic livers (30%-60%) represent a risk for worsened graft function is controversial. The uncertainty, in large part, is owing to the heterogeneous steatosis grading. Our aim was to determine the short- and long-term outcomes of moderately macrosteatotic allografts that were graded according to a standardized institutional protocol.

methodsWe performed a retrospective analysis of transplants performed between 1994 and 2014. All patients with allografts biopsied pretransplantation were included. Relevant donor and recipient variable were recorded. Moderately macrosteatotic livers were compared with mildly macrosteatotic and nonsteatotic livers. Primary outcomes of interest were patient survival at 90 days, 1 year, and 5 years. Cox regression analyses were carried out to compare survival between the 2 groups.

resultsWe compared 65 allografts with moderate macrosteatosis and 810 with no or mild macrosteatosis. Patients with moderately macrosteatotic allografts were 2.69 times as likely to die within the first 90 days after transplant (75.1% vs 91.6% survival) after adjusting for donor age, donor race, recipient age, recipient race, recipient body mass index, recipient diabetes, presence of hepatocellular carcinoma, days on waitlist, Model for End-Stage Liver Disease (MELD) score at transplantation, cold ischemia time. However, for recipients who survive 90 days, moderately macrosteatotic allografts had comparable long-term survival.

conclusionOur study shows that moderate macrosteatosis is a strong predictor of early but not late mortality. Further studies are needed to distinguish the specific cohort of patients for whom moderately macrosteatotic allografts will lead to acceptable outcomes.

Indexed as

Liver TransplantationAdultAgedBody Mass IndexEnd Stage Liver DiseaseFatty LiverFemaleHumansKaplan-Meier EstimateLiverMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesSeverity of Illness IndexTransplantation, Homologous

Identifiers

PMID33931249
PMCPMC8628849
OpenAlexW3158670052

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.