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.