Era of metabolic dysfunction-associated steatotic liver disease and impact on the liver donor pool

Table 1 Outcomes in liver graft according to the degree of steatosis

Steatosis grade	Steatosis range (%)	1-year survival (%)	Associated risks	Risk of PNF	Additional notes	Ref.
Grade 1 (low risk)	< 30	> 90	Low risk of DGF and PNF	Very low (almost nonexistent)	Grafts with low risk, acceptable for a wide variety of recipients. Very low rates of PNF and DGF	[21]
Grade 2 (moderate risk)	30-60	89-90	Moderate risk of DGF and PNF	Moderate	Requires careful recipient evaluation and optimized perioperative management. Use of NMP improves outcomes	[5,22]
Grade 3 (high risk)	> 60	< 80	High risk of PNF, early allograft dysfunction, and increased mortality	High	High rate of ischemia-reperfusion injury and graft dysfunction. Use of NMP may improve outcomes when the right recipient is selected	[5,17,22]

PNF: Primary nonfunction; DGF: Delayed graft dysfunction; NMP: Normothermic machine perfusion.