Table 1.

Summary of the Literature Examining Careful Recipient Selection to Minimize Risks Associated With Steatotic Donor Livers

Author	Year	N	% ld‐MaS	Outcome	Characteristics Associated With Acceptable Outcome
Chavin et al.6	2013	9	>60%	Patient and graft survival	Donor/recipient selection algorithm: Recipient/donor pairs with fewer than two factors from each set of characteristics had equivalent outcomes with >60% ld‐MaS grafts and nonsteatotic grafts.
					Donor risk factors: age >60 years, vasopressor use, ICU stay >48 hours, elevated LFTs, sodium ≥155 mEq/L, acute myocardial infarction, diabetes, BMI ≥ 40
					Recipient risk factors: age >60 years, fulminant liver failure, prior transplant recipient, portal vein thrombosis, multiple abdominal surgeries, spontaneous bacterial peritonitis, MELD score >30, BMI ≥ 40
Dutkowski et al.7	2012	530	≥30%	Patient and graft survival	Although recipients of steatotic grafts with a BAR score ≤9 had a 1.33‐fold adjusted increase in risk for graft failure with a ≥30% ld‐MaS liver, 1‐year graft survival was still considered to be acceptable (82% versus 86%).
McCormack et al.11	2007	20	>60%	Patient survival	Recipients with a MELD score ≤24 or in acute liver failure who received a >60% ld‐MaS graft had an equivalent 3‐year patient survival rate with nonsteatotic grafts (83% versus 84%).

In each of these studies, there was a specific focus on recipient selection (either prospectively or retrospectively) to find a group of recipients who might have similar outcomes with either a steatotic or a nonsteatotic liver. Although several other studies have shown no, or minimal, differences in posttransplant outcomes when using livers with moderate or severe ld‐MaS, those studies have considered their entire transplant population, without specifically identifying a group of recipients in whom the risks of a steatotic liver were minimized.