# Expanding the donor pool: Outcomes of liver transplantation using grafts with ≥50% macrosteatosis

## TL;DR

This study shows that liver transplants using fatty donor livers can be successful, though they come with some risks.

## Contribution

The study demonstrates the viability of using high-macrosteatosis liver grafts in low-to-intermediate MELD recipients.

## Key findings

- All five patients survived beyond one year with functioning grafts.
- Two patients experienced thrombotic complications requiring reoperations.

## Abstract

Liver grafts with over 50% macrosteatosis are often deemed marginal, but organ shortages necessitate exploring their use. We conducted five transplants with deceased donor grafts containing 50%–90% macrosteatosis, ensuring donor age <55 years, CIT ≤6 hours, and recipient laboratory MELD score ≤30. Two patients required reoperations due to thrombotic complications (acute HAT and PVT), and hospital stay ranged from 6 to 26 days. All patients survived beyond one year with functioning grafts. These findings suggest the feasibility of using high-macrosteatosis grafts in intermediate- to low-laboratory-MELD recipients, albeit with potential thrombotic risks.