Study: Pre-Transplant Liver Biopsy Recommended for Prospective Donors

Conducting a pre-transplant liver biopsy on a prospective donor can lead to the discovery of potential complications and improve prospects for a successful living-donor liver transplant, according to researchers at Cedars-Sinai Medical Center in Los Angeles.

The researchers say the biopsy -- required as a pre-transplant screening test by only about ten percent of U.S. centers performing living-donor liver transplants -- can detect abnormalities in potential liver donors that might go unnoticed through the usual laboratory and imaging tests.

"We want to avoid operating on donors whose livers are ultimately unacceptable for transplant, and we want the patient to achieve the best result possible after the transplant is completed," said Dr. Tram Tran, assistant director of the Liver Transplant Program at Cedars-Sinai.

Reporting on 56 donors who donated a lobe of their liver in the Cedars-Sinai living donor liver transplant program between May 2001 and Oct. 2002, Tran said all 56 showed no obvious abnormalities in screenings that included physical exams, extensive blood testing, imaging and further clinical evaluations.

But subsequent biopsies found chronic hepatitis, severe fat in the liver and other liver complications in some of the prospective donors that would not have been detected without the liver biopsy. Tran said only 27 percent of these donors had livers as healthy as the screenings, alone, had indicated.

"We feel that a donor biopsy is very valuable in detecting abnormalities that we might miss through routine screenings," said Tran. "We recognize that there is a one percent risk of bleeding with a liver biopsy but we feel the risk is justified in that the lives of two people are at stake."

"Based on the results of our analysis, we're now recommending that all centers offering living donor liver transplants consider adding a pre-transplant donor biopsy to their screening process," said Dr. John Vierling, Medical Director of the Multi-Organ Transplant Program at Cedars-Sinai.

Other Sources: Cedars-Sinai