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Banff consensus recommendations for steatosis assessment in donor livers
Desley A H Neil1,2, Marta Minervini3, Maxwell L Smith4
1Department of Cellular PathologyQueen Elizabeth Hospital BirminghamBirminghamUK.
Hepatology (Baltimore, Md.)
|October 22, 2021
Summary
Standardized criteria for assessing liver steatosis in donor livers are needed. This study established consensus guidelines for evaluating fat droplet size and percentage of affected hepatocytes to improve donor liver suitability assessments.
Area of Science:
- Hepatology
- Transplantation Pathology
- Diagnostic Pathology
Background:
- Lack of standardized criteria for assessing steatosis in donor liver biopsies hinders transplantation suitability assessments.
- The Banff Working Group on Liver Allograft Pathology investigated current practices and aimed to establish consensus.
Purpose of the Study:
- To determine the consistency of steatosis assessment in donor liver frozen sections.
- To establish consensus criteria for defining large droplet fat (LDF) and develop an algorithmic approach for severity assessment.
Main Methods:
- A global survey of 59 pathologists on steatosis assessment criteria.
- Assessment of 18 donor liver frozen sections by the surveyed pathologists.
- Workshop discussions at the 15th Banff Conference on Allograft Pathology to reach consensus.
Main Results:
- Significant variation in steatosis assessment definitions and approaches was reported by 56/59 pathologists.
- Whole slide image assessment resulted in a wide range of steatosis scores.
- Consensus was reached on defining LDF and an algorithmic approach for severity estimation.
Conclusions:
- Proposed guidelines aim to standardize steatosis assessment in donor liver biopsies.
- Standardized assessment will improve the reliability of donor liver suitability evaluations.
- Reporting the calculated percent LDF to surgeons is recommended.
