10 February 2026 : Original article
Inferior Long-Term Outcome of Fatty Liver Allografts After Orthotopic Liver Transplantation
Svenja Krause BDEF 1, Helena Maria Linge CE 1, Ulrich Zwirner
BE 1, Alexander Wagner BE 1, Nicolas Richter BDE 1, Moritz Schmelzle ADE 1, Ulf Kulik ABCDEF 1*
DOI: 10.12659/AOT.950589
Ann Transplant 2026; 31:e950589
Table 1 Comparison of recipient and donor clinical data of donor recipients receiving grafts without (group A) and with (group B) steatosis.
| Liver transplantation (OLT)N=337 | No signs of steatosis in graft (group A) n=205Median (range) or n (%) | Missing values | Steatosis in graft (group B) n=132 Median (range) or n (%) | Missing values N (%) | P valueChi2 test |
|---|---|---|---|---|---|
| Female | 85 (41.5%) | 0 (0%) | 49 (37.1%) | 0 (0%) | 0.104 |
| Male | 120 (58.5%) | 0 (0%) | 83 (62.9%) | 0 (0%) | |
| Age (years) | 50.0 (19–73) | 0 (0%) | 53.0 (23–69) | 0 (0%) | 0.420 |
| BMI | 25.0 (17–42) | 3 (1.5%) | 25.5 (17.7–39.5) | 1 (0.75%) | 0.269 |
| Indication for OLT | |||||
| Ethyl-tox/crypt. cirrhosis | 41 (20.0%) | 0 (0%) | 21 (15.9%) | 0 (0%) | 0.098 |
| HBV-/HCV-related cirrhosis | 23 (11.2%) | 16 (12.1%) | |||
| HCC/NEC-Metastases | 43 (21.0%) | 44 (33.3%) | |||
| PSC/PBC | 37 (18.0%) | 20 (15.2%) | |||
| (Sub-)Acute liver failure | 27 (13.2%) | 11 (8.3%) | |||
| Others | 34 (16.6%) | 20 (15.2%) | |||
| Laboratory MELD | 16.9 (5–40) | 50 (24.4%) | 14.6 (7–40) | 31 (23.5%) | 0.568 |
| Time on waiting list | 239.0 (1–40769) | 0 (0%) | 179.0 (1–38865) | 0 (0%) | 0.195 |
| Encephalopathy (yes) | 57 (27.8%) | 0 (0%) | 34 (28.8%) | 4 (3.1%) | 0.620 |
| Hemodialysis pre-OLT (yes) | 22 (10.8%) | 2 (1.0%) | 18 (13.6%) | 4 (3.1%) | 0.083 |
| Respirator treatment pre-OLT (yes) | 14 (6.9%) | 2 (1.0%) | 6 (4.5%) | 5 (3.8%) | 0.106 |
| Female | 95 (46.3%) | 0 (0%) | 51 (38.6%) | 0 (0%) | 0.104 |
| Male | 110 (53.7%) | 81 (61.4%) | |||
| Age (years) | 50.0 (16–88) | 1 (0.5%) | 54.0 (18–78) | 2 (1.5%) | <0.001 |
| BMI | 26.0 (16–46) | 1 (0.5%) | 28.0 (19–55) | 2 (1.5%) | 0.386 |
| IDDM/NIDDM | 16 (7.8%) | 2 (1.0%) | 17 (12.9%) | 2 (1.5%) | 0.002 |
| Insulin treatment | 64 (31.2%) | 0 (0%) | 34 (25.8%) | 4 (3.1%) | 0.056 |
| ICU stay (days) | 4.0 (1–41) | 2 (1.0%) | 4.0 (1–24) | 3 (2.3%) | 0.608 |
| AST (U/L) | 38.0 (1–1623) | 4 (2.0%) | 44.0 (11–831) | 7 (5.3%) | 0.929 |
| ALT (U/L) | 30.0 (0–821) | 3 (1.5%) | 32.0 (6–584) | 3 (2.3%) | 0.946 |
| Sodium (mmol/L) | 147.0 (129–197) | 2 (1.0%) | 149.0 (132–189) | 2 (1.5%) | 0.602 |
| CIT (min) | 616.5 (222–1969) | 5 (2.4%) | 581.0 (310–1174) | 6 (4.5%) | 0.069 |
| Duration of surgery | 200.0 (108–434) | 4 (2.0%) | 212.0 (118–405) | 3 (2.3%) | 0.372 |
| Primary abdominal closure (yes) | 165 (81.7%) | 3 (1.5%) | 90 (68.2%) | 4 (3.1%) | <0.001 |
| Complications graded Dindo ≥3 | 157 (76.6%) | 0 (0%) | 97 (73.5%) | 0 (0%) | 0.205 |
| Primary nonfunction | 18 (8.8%) | 0 (0%) | 20 (15.2%) | 0 (0%) | <0.001 |
| Re-OLT | 13 (6.3%) | 0 (0%) | 15 (11.4%) | 0 (0%) | 0.001 |
| ICU stay (days) | 11 (1–187) | 0 (0%) | 13 (1–277) | 0 (0%) | 0.078 |
| Hospital stay (days) | 33 (1–202) | 0 (0%) | 36.5 (1–277) | 0 (0%) | 0.116 |
| In-house mortality | 25 (12.2%) | 0 (0%) | 27 (20.5%) | 0 (0%) | <0.001 |
| BMI – body mass index; AST – aspartate aminotransferase; OLT – orthotopic liver transplantation; MELD – model for end-stage liver disease; ICU – intensive care unit; CIT – cold ischemia time; HCC/NEC – hepatocellular carcinoma/neuroendocrine; PCS/PBC – primary sclerosing cholangitis/primary biliary cholangitis; IDDM – insulin-dependent diabetes mellitus; NIDDM – non–insulin-dependent diabetes mellitus. | |||||