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In preparation for the British Liver Transplant Group meeting in York in September, this is a small study of inter-observer variation in the reporting of donor liver biopsies sent for assessment of steatosis.  It will probably take you 20-30 minutes to do.

The study will be in two parts - at this first stage, please will you report the cases with an estimate of the % hepatocytes showing macrovesicular steatosis, and a comment if required. Please also indicate in the question at the beginning if you normally estimate a % of steatosis or report on a scale of none/mild/moderate/severe, and whether you separately assess macro and microvesicular steatosis.  You may report other abnormalities in the biopsy.
 
We plan to follow this initial phase with a re-labelling of the slides, and then a second round with guidance on reporting and a repeat assessment of inter-observer variation.
 
Please will you encourage all the pathologists who provide this out of hours service to take part in the study. Please include your name and transplant centre - if you feel uncomfortable about doing this please make up a nickname for yourself which you will use again in the second part of the study - (but you will not be able to claim a CPD point if you do this).
 
many thanks for your help,
Judy and Desley.

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* 1. Name of transplant centre:

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* 2. your name (or a nickname you can remember for the next time)

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* 3. How do you usually report out of hours donor frozen section liver biopsies for macrovesicular steatosis?

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* 4. Do you usually include a separate assessment of microvesicular/small droplet steatosis?

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* 5. Case 1  % macrovesicular steatosis

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* 6. additional features/comment

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* 7. Case 2  % macrovesicular steatosis

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* 8. additional features/comment

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* 9. Case 3  % macrovesicular steatosis

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* 10. additional features/comment

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* 11. Case 4  % macrovesicular steatosis

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* 12. additional features/comment

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* 13. Case 5  % macrovesicular steatosis

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* 14. additional features/comment

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* 15. Case 6  % macrovesicular steatosis

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* 16. additional features/comment

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* 17. Case 7  % macrovesicular steatosis

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* 18. additional features/comment

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* 19. Case 8  % macrovesicular steatosis

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* 20. additional features/comment

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* 21. Case 9  % macrovesicular steatosis

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* 22. additional features/comment

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* 23. Case 10  % macrovesicular steatosis

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* 24. additional features/comment

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* 25. Case 11  % macrovesicular steatosis

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* 26. additional features/comment

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* 27. Case 12  % macrovesicular steatosis

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* 28. additional features/comment

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* 29. Case 13  % macrovesicular steatosis

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* 30. additional features/comment

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* 31. Case 14  % macrovesicular steatosis

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* 32. additional features/comment

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* 33. Case 15  % macrovesicular steatosis

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* 34. additional features/comment

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* 35. Case 16  % macrovesicular steatosis

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* 36. additional features/comment

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* 37. Case 17  % macrovesicular steatosis

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* 38. additional features/comment

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* 39. Case 18  % macrovesicular steatosis

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* 40. additional features/comment

Thank you for sending your responses.  
There will be a second part to this study, in a month or so.  Our aim is to achieve a more evidence-based and consistent assessment of donor liver biopsies, to optimise the use of donor organs.  Also to provide an on line resource to support pathologists making these assessments. 

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