Evidence mapPaperPMID 42569461Full record

ArticleHepatobiliary surgery and nutrition2026

Liver donor macrosteatosis is associated with adverse long-term outcomes exclusively in metabolic dysfunction-associated steatotic liver disease recipients: a U.S. transplant registry analysis over the last decade.

Leandro Sierra, Butros Fakhoury, Kanisha Bahierathan, Maria Saavedra-Martinez, Maria Ortega Abad, Lily Liu, Vinay Jahagirdar, Pojsakorn Danpanichkul, Katherine M Cooper, Luis Antonio Diaz and 1 more

Abstract read
In one paragraph

Article in Hepatobiliary surgery and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leandro SierraDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-7148-5450
Butros FakhouryDivision of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0001-6909-6328
Kanisha BahierathanCase Western Reserve University School of Medicine, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-8319-8176
Maria Saavedra-MartinezFacultad de Medicina, Universidad de La Sabana, Chía, Colombia.ORCID https://orcid.org/0009-0002-1054-686X
Maria Ortega AbadEndocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0009-0007-3547-5312
Lily LiuDepartment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0009-0008-1188-9323
Vinay JahagirdarDivision of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0001-6685-1033
Pojsakorn DanpanichkulDepartment of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.ORCID https://orcid.org/0000-0002-9121-165X
Katherine M CooperDivision of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-6030-4773
Luis Antonio DiazMASLD Research Center, Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, California, USA.ORCID https://orcid.org/0000-0002-8540-4930
Juan Pablo ArabDivision of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0002-8561-396X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Liver grafts with >30% macrovesicular steatosis (Mas30) have shown acceptable long-term graft survival (GS) in steatotic liver disease (SLD) recipients. However, grouping SLD etiologies under a single umbrella ignores their distinct metabolic profiles and may lead to suboptimal allocation decisions. Considering the 2023 Delphi consensus nomenclature, we aimed to compare early and long-term GS following Mas30 liver transplantation (LT) across SLD subtypes. Methods: We analyzed adult LT recipients in the U.S. national transplant registry from 2014 to 2024. Donor macrovesicular steatosis was categorized as none (<5%), mild (5-30%), and Mas30 (>30%). SLD recipients were classified as metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related liver disease (MetALD), or alcohol-associated liver disease (ALD). Primary endpoints were early (90-day) and long-term (3-year) GS. Time-to-event analyses were conducted using Kaplan-Meier and multivariable Cox regression. Results: Among 27,164 LT recipients (14,270 SLD and 12,894 non-SLD), Mas30 utilization declined over time (P<0.001). MASLD recipients of Mas30 grafts had reduced early GS (87.8% Conclusions: MASLD recipients receiving Mas30 grafts experience substantially reduced GS extending to 3 years post-LT, while MetALD and ALD recipients remain unaffected. Our findings support etiology-specific allocation strategies for steatotic liver grafts.

Indexed as

graft survival (GS)liver transplantation (LT)macrovesicular steatosisorgan allocationSteatotic liver disease (SLD)

Identifiers

PMID42569461
PMCPMC13450002

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.