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FamilyPhysician
FamilyPhysician, MD, MBA
Category: General
Satisfied Customers: 12623
Experience:  Primary care physician for transplant patients
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my 26 year old nephew is unresponsive in icu and has been awaiting

Resolved Question:

my 26 year old nephew is unresponsive in icu and has been awaiting a liver for about 5 days. His brain is still normal but the doctors fear he is running out of time. They have a liver coming in 12 hours from a deceased obese person and the family is trying to understand what complications may arise from the fat cells. Please explain what this means.
Submitted: 2 years ago.
Category: Organ Transplantation
Expert:  FamilyPhysician replied 2 years ago.
Thank you for your question:

Have the doctors caring for your nephew expressed concern about the fact that the donor is obese?

What was the cause of your nephew's liver failure?
Customer: replied 2 years ago.
Not really, the docs just said that 2 other people had turned the liver down because the donor was obese, however, my nephew is running out of time because the doc is worried about brain damage at this point. His ammonia levels and all the other stuff was down today and this was just a small window of opportunity for the transplant. The doc said she would look at the liver when it arrived and if something was wrong with it, he would remain on the translplant list. They have not really diagnosed his liver failure, there has been some mention of an autoimmune disease. He walked out of a Hiland Dairy plant 25 days ago and everyone gasped at the fact that he was neon yellow! He was glowing! He immediately came home to the local E.R. and they sent him straight to the liver transplant center in OKC. The family is suspecting some type of poisoning from the chemicals that he works with on his job installing flooring and wall tiles containing pesticides. His liver was 90% damaged from day 1 and he has deteriorated rapidly.
Expert:  FamilyPhysician replied 2 years ago.
Thank you for the additional information.

There are a number of factors that influence the success/survival of a donor liver. The severity of steatosis ("fatty liver") is one of many factors. An obese patient is more likely to have this problem, however, if the degree of steatosis is not so severe, there is actually a good chance that this organ would be adequate.

Here is an article on this issue. As you can see, the most severe type of steatosis is a reason not to use a particular donor organ, however the less severe forms actually are not a contraindication (reason to not use) the organ.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103099/?tool=pubmed

Hopefully things go well when the organ arrives. Please let me know how things do progress.

If you need additional help, please feel free to reply, and I will try to answer to the best of my ability.
FamilyPhysician, MD, MBA
Satisfied Customers: 12623
Experience: Primary care physician for transplant patients
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