Utility of pre-procurement bedside liver biopsy in the deceased extended-criteria liver donor

Richard S. Mangus, Tim C. Borup, Sam Popa, Romil Saxena, Oscar Cummings, A. Joseph Tector

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Introduction: The Indiana Organ Procurement Organization (IOPO) utilizes preoperative bedside liver biopsies in certain extended-criteria donors (ECDs), obtained by the on-site coordinator, to determine the utility of pursuing donation. This study reports the clinical and financial outcomes for this management strategy. Methods: All bedside liver biopsies obtained in ECDs over a five-yr period were reviewed. Study variables included the following: indication for biopsy, biopsy results, taking the case to the operating room, transplantation of the donor liver, and graft survival. All biopsies were processed at a single university center. Results: There were 110 donors biopsied. Primary indications included the following: old age (29%), extensive/current alcohol abuse (26%), hepatitis C-positive serology (21%), obesity (25%), and severely elevated liver function enzymes (18%). Biopsy results demonstrated a potentially transplantable liver in 73 cases (66%), all of whom were taken to the OR (while 37 ruled out for donation based upon liver biopsy [34%]). Of all biopsied livers, 49 ultimately were transplanted (45%). Intra-operative decisions included the following: transplant 51/73 (70%), surgeon decision to exclude 20/73 (27%), nonuse due to finding of malignancy two (3%). Conclusions: Bedside liver biopsy may be a valuable tool to determine the utility in pursuing donation in ECDs, particularly with liver-only donors.

Original languageEnglish (US)
Pages (from-to)1358-1364
Number of pages7
JournalClinical Transplantation
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Extended-criteria donor
  • Liver biopsy
  • Liver transplantation
  • Organ procurement

ASJC Scopus subject areas

  • Transplantation
  • Medicine(all)

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