Value of an individual liver biopsy in the preoperative evaluation of apparently healthy potential l

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Original Articles

Value of an individual liver biopsy in the preoperative evaluation of apparently

healthy potential liver donors

Nurten Savas 1 *, Mehmet Coskun 2, Banu Bilezikci 3, Irfan Uruc 1, Hamdi

Karakayali 4, Ugur Yilmaz 1, Mehmet Haberal 4

1Department of Gastroenterology, Baskent University, Ankara, Turkey

2Department of Radiology, Baskent University, Ankara, Turkey

3Department of Pathology, Baskent University, Ankara, Turkey

4Department of General Surgery and Transplantation, Baskent University, Ankara,

Turkey

email: Nurten Savas (nakyurek2000@...)

*Correspondence to Nurten Savas, Department of Gastroenterology, Baskent

University, M. Fevzi Cakmak Cad., 5. Sok. No. 48, Bahcelievler, Ankara, Turkey

06490

See Editorial on Page 420

Telephone: 90 312 212 29 12; Fax: 90 312 215 42 16

Abstract

Living donor liver transplantation has acquired widespread acceptance. A

thorough workup of the potential living donor is guided by 2 objectives: the

first is ensuring the safety of the surgical procedure for the donor, and the

second is identifying donor grafts that pose potential risks for the recipient.

Of 305 living-related liver donors, liver biopsy was performed in 201. The

results of those patients' liver function tests and serologic tests were within

normal limits. Forty-one of the 201 patients had steatosis on abdominal

ultrasonography or tomography. Of 201 liver biopsies, 94 (46.8%) demonstrated

normal findings, whereas 107 (53.2%) showed abnormal findings on pathology. Of

107 patients with abnormal pathological findings, 32 (29.9%) had fatty changes,

4 (3.7%) had steatohepatitis, and 71 (66.4%) had nonsteatotic histologic

findings including fibrosis, hepatitis, and granulomatous reactions. In

conclusion, our data show that half of the living-related liver donors,

appearing absolutely healthy, had biopsies with abnormal pathology results. As

it is well known that increasing percentages of steatosis may reduce the

functional mass of the graft and occult liver diseases may not be detected

without liver biopsy, we recommend that liver biopsies be part of the routine

evaluation protocol for living-related liver donors in all transplantation

institutions. Liver Transpl 14:541-546, 2008. © 2008 AASLD.

_________________________________________________________________

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[Guest guest]

Original Articles

Value of an individual liver biopsy in the preoperative evaluation of apparently

healthy potential liver donors

Nurten Savas 1 *, Mehmet Coskun 2, Banu Bilezikci 3, Irfan Uruc 1, Hamdi

Karakayali 4, Ugur Yilmaz 1, Mehmet Haberal 4

1Department of Gastroenterology, Baskent University, Ankara, Turkey

2Department of Radiology, Baskent University, Ankara, Turkey

3Department of Pathology, Baskent University, Ankara, Turkey

4Department of General Surgery and Transplantation, Baskent University, Ankara,

Turkey

email: Nurten Savas (nakyurek2000@...)

*Correspondence to Nurten Savas, Department of Gastroenterology, Baskent

University, M. Fevzi Cakmak Cad., 5. Sok. No. 48, Bahcelievler, Ankara, Turkey

06490

See Editorial on Page 420

Telephone: 90 312 212 29 12; Fax: 90 312 215 42 16

Abstract

Living donor liver transplantation has acquired widespread acceptance. A

thorough workup of the potential living donor is guided by 2 objectives: the

first is ensuring the safety of the surgical procedure for the donor, and the

second is identifying donor grafts that pose potential risks for the recipient.

Of 305 living-related liver donors, liver biopsy was performed in 201. The

results of those patients' liver function tests and serologic tests were within

normal limits. Forty-one of the 201 patients had steatosis on abdominal

ultrasonography or tomography. Of 201 liver biopsies, 94 (46.8%) demonstrated

normal findings, whereas 107 (53.2%) showed abnormal findings on pathology. Of

107 patients with abnormal pathological findings, 32 (29.9%) had fatty changes,

4 (3.7%) had steatohepatitis, and 71 (66.4%) had nonsteatotic histologic

findings including fibrosis, hepatitis, and granulomatous reactions. In

conclusion, our data show that half of the living-related liver donors,

appearing absolutely healthy, had biopsies with abnormal pathology results. As

it is well known that increasing percentages of steatosis may reduce the

functional mass of the graft and occult liver diseases may not be detected

without liver biopsy, we recommend that liver biopsies be part of the routine

evaluation protocol for living-related liver donors in all transplantation

institutions. Liver Transpl 14:541-546, 2008. © 2008 AASLD.

_________________________________________________________________

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http://www.windowslive.com/messenger/overview.html?ocid=TXT_TAGLM_WL_Refresh_get\

intouch_042008