• graft dysfunction;
  • liver donation;
  • liver steatosis;
  • MELD


Prognosis after liver transplantation depends on a combination of recipient and donor variables. The purpose of this study is to define an allocation system of steatotic donor livers relative to recipient model for end-stage liver disease (MELD) score. We reviewed 500 consecutive OLT, computing the MELD score for each recipient. Fatty infiltration in grafts was categorized in no steatosis, 10–30%, 30–60% and ≥60% steatosis. MELD score did not affect preservation injury and graft dysfunction, which were increased with fat content. Recipient and graft survivals lowered when increasing MELD score. Outcome in low-risk recipients (MELD ≤9) was not altered with steatosis, except those with ≥60%. Survival functions in moderate-risk recipients (MELD 10–19) were moderately affected with 10–30% steatosis and severely with those with >30. Exactly 30–60% steatotic grafts work poorly in high-risk recipients (MELD ≥20), and very poorly with ≥60% steatosis. Prognosis of candidates is optimally influenced when divergence of recipient–donor risks is presented.