Assessment of Liver Transplant Donor Biopsies for Steatosis Using Frozen Section: Accuracy and Possible Impact on Transplantation

BACKGROUND: Pre-transplant frozen section evaluation for macrovesicular steatosis has long been used as a guide for donor liver utility, but may not agree with the permanent section evaluation. This study sought to evaluate the accuracy of frozen section in an active transplant service. METHODS: Retrospective review of cases where frozen section analysis was undertaken to assess percent macrovesicular steatosis was performed, comparing the frozen section diagnosis to the final diagnosis. RESULTS: Ninety-six cases were available for review. In 7 of these cases (7%), the difference between the two slides was significant; that is, the difference between the two slides may have contributed to a change in clinical management at a cutoff of 30%. CONCLUSIONS: Clinicians need to be aware that accuracy is satisfactory in experienced hands but some discrepancies may occur. KEYWORDS: Liver; Steatosis; Pathology