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

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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, Turkey2Department of Radiology, Baskent University, Ankara, Turkey3Department of Pathology, Baskent University, Ankara, Turkey4Department 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 06490See Editorial on Page 420Telephone: 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.

Received: 15 February 2007; Accepted: 29 October 2007

Digital Object Identifier (DOI)10.1002/lt.21410