Discontinuation of Living Donor Liver Transplantation for PSC Due to Histological Abnormalities in Intraoperative Donor Liver Biopsy

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Discontinuation of Living Donor Liver Transplantation for PSC Due to Histological Abnormalities in Intraoperative Donor Liver Biopsy

Authors: Hasegawa, Y.1; Kawachi, S.; Shimazu, M.2; Hoshino, K.1; Tanabe, M.1; Fuchimoto, Y.1; Obara, H.1; Shinoda, M.1; Shimizu, H.1; Yamada, Y.1; Akatsu, T.1; Irie, R.3; Sakamoto, M.4; Morikawa, Y.1; Kitajima, M.1

Source: American Journal of Transplantation, Volume 7, Number 9, September 2007 , pp. 2204-2207(4)

Abstract:

Liver transplantation is the only curative treatment known to date for end-stage liver disease occurring as a result of primary sclerosing cholangitis (PSC). Here, we report a case in which living donor liver transplantation (LDLT) for PSC was cancelled because of histological abnormalities in intraoperative biopsy of the donor liver. The donor was the mother of the recipient, and her preoperative evaluation revealed no abnormalities. In the donor operation, the donor liver biopsy revealed expansion of the portal zone with lymphocytic infiltration and dense concentric fibrosis developed around a bile duct. These histological findings were identical to those of early-stage PSC; therefore, the LDLT was called off. The experience in this case suggests that preoperative liver biopsy may be useful to exclude first-degree relative donors with potential PSC prior to LDLT for PSC.

Keywords: Donor operation; first degree relative donor; liver biopsy; living donor liver transplantation; PSC

Document Type: Research article

DOI: 10.1111/j.1600-6143.2007.01898.x

Affiliations: 1: Department of Surgery, Keio University School of Medicine, Tokyo, Japan 2: Department of Digestive Surgery, Tokyo Medical University Hachioji Medical Center 3: Division of Diagnostic Pathology 4: Department of Pathology, Keio University School of Medicine, Tokyo, Japan