TY - JOUR
T1 - Digital imaging software versus the "eyeball" method in quantifying steatosis in a liver biopsy
AU - Long, Jane J.
AU - Nijhar, Kieranjeet
AU - Jenkins, Reed T.
AU - Yassine, Adham
AU - Motter, Jennifer D.
AU - Jackson, Kyle R.
AU - Jerman, Stephanie
AU - Besharati, Sepideh
AU - Anders, Robert A.
AU - Dunn, Ty B.
AU - Marsh, Christopher L.
AU - Rayapati, Divya
AU - Lee, David D.
AU - Barth, Rolf N.
AU - Woodside, Kenneth J.
AU - Philosophe, Benjamin
N1 - Publisher Copyright:
© 2023 John Wiley and Sons Ltd. All rights reserved.
PY - 2023/3
Y1 - 2023/3
N2 - Steatotic livers represent a potentially underutilized resource to increase the donor graft pool; however, 1 barrier to the increased utilization of such grafts is the heterogeneity in the definition and the measurement of macrovesicular steatosis (MaS). Digital imaging software (DIS) may better standardize definitions to study posttransplant outcomes. Using HALO, a DIS, we analyzed 63 liver biopsies, from 3 transplant centers, transplanted between 2016 and 2018, and compared macrovesicular steatosis percentage (%MaS) as estimated by transplant center, donor hospital, and DIS. We also quantified the relationship between DIS characteristics and posttransplant outcomes using log-linear regression for peak aspartate aminotransferase, peak alanine aminotransferase, and total bilirubin on postoperative day 7, as well as logistic regression for early allograft dysfunction. Transplant centers and donor hospitals overestimated %MaS compared with DIS, with better agreement at lower %MaS and less agreement for higher %MaS. No DIS analyzed liver biopsies were calculated to be >20% %MaS; however, 40% of liver biopsies read by transplant center pathologists were read to be >30%. Percent MaS read by HALO was positively associated with peak aspartate aminotransferase (regression coefficient= 1.041.081.12, p<0.001), peak alanine aminotransferase (regression coefficient =1.041.081.12, p<0.001), and early allograft dysfunction (OR=1.101.401.78, p=0.006). There was no association between HALO %MaS and total bilirubin on postoperative day 7 (regression coefficient =0.991.011.04, p=0.3). DIS provides reproducible quantification of steatosis that could standardize MaS definitions and identify phenotypes associated with good clinical outcomes to increase the utilization of steatite livers.
AB - Steatotic livers represent a potentially underutilized resource to increase the donor graft pool; however, 1 barrier to the increased utilization of such grafts is the heterogeneity in the definition and the measurement of macrovesicular steatosis (MaS). Digital imaging software (DIS) may better standardize definitions to study posttransplant outcomes. Using HALO, a DIS, we analyzed 63 liver biopsies, from 3 transplant centers, transplanted between 2016 and 2018, and compared macrovesicular steatosis percentage (%MaS) as estimated by transplant center, donor hospital, and DIS. We also quantified the relationship between DIS characteristics and posttransplant outcomes using log-linear regression for peak aspartate aminotransferase, peak alanine aminotransferase, and total bilirubin on postoperative day 7, as well as logistic regression for early allograft dysfunction. Transplant centers and donor hospitals overestimated %MaS compared with DIS, with better agreement at lower %MaS and less agreement for higher %MaS. No DIS analyzed liver biopsies were calculated to be >20% %MaS; however, 40% of liver biopsies read by transplant center pathologists were read to be >30%. Percent MaS read by HALO was positively associated with peak aspartate aminotransferase (regression coefficient= 1.041.081.12, p<0.001), peak alanine aminotransferase (regression coefficient =1.041.081.12, p<0.001), and early allograft dysfunction (OR=1.101.401.78, p=0.006). There was no association between HALO %MaS and total bilirubin on postoperative day 7 (regression coefficient =0.991.011.04, p=0.3). DIS provides reproducible quantification of steatosis that could standardize MaS definitions and identify phenotypes associated with good clinical outcomes to increase the utilization of steatite livers.
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U2 - 10.1097/LVT.0000000000000064
DO - 10.1097/LVT.0000000000000064
M3 - Article
C2 - 36651194
AN - SCOPUS:85148678203
SN - 1527-6465
VL - 29
SP - 268
EP - 278
JO - Liver Transplantation
JF - Liver Transplantation
IS - 3
ER -