Frozen Section Evaluation of Donor Liver for Transplantation

Subject:

Frozen section evaluation of a donor liver is frequently performed to evaluate suitability for use

Is there fat?
- Give percent of hepatocytes involved by macrovesicular (large droplet) fat
  - Severe macrovesicular steatosis is defined as involvement of >60% of parenchyma
- Presence or absence of microvesicular fat should be commented on
- Current standards based on evaluation of H&E stain, not fat stain
Is there underlying liver disease?
- Rule out chronic hepatitis
  - If present, grade and stage
Is there evidence of malignancy?
Abundant lipofuscin may be seen in older donors
- Typically centrilobular
- No significance
Severe macrovesicular fat or malignancy are contraindications for transplantation

Neeraja Kambham MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342