Living donor liver transplantation: histological abnormalities found on liver biopsies of apparently healthy potential donors.
OBJECTIVE
With the continued shortage of deceased donor grafts, living donor liver transplantation has become an option for adult liver transplant candidates. In the non-transplant setting, liver biopsy is typically carried out to evaluate clinical or biochemical hepatic dysfunction. In living donor liver transplantation, assessment of histological abnormalities that are undetectable by serological, biochemical and radiological methods might play an important role in donor and recipient outcome.


METHODS
Seventy consecutive liver biopsies carried out as part of our evaluation of potential donor candidates for adult-to-adult or adult-to-child living donor liver transplants were analyzed.


RESULTS
Of the 70 potential donor candidates who underwent liver biopsy for evaluation for living donor liver transplantation, 67% had an unexpected abnormality, of which steatosis was the most common abnormality (38.5%). A variety of other histopathological abnormalities were found including granulomas of unknown etiology (7%), chronic hepatitis (6%) and a microabscess. None of the histological abnormalities had been suspected despite extensive clinical, serological or radiological investigation.


CONCLUSIONS
Among the 70 potential donor candidates for living donor liver transplantation, 34% had unremarkable liver biopsies. The most common abnormality was steatosis (38.5%). These findings suggest that all potential candidates for living donor liver transplants should undergo screening liver biopsies. The precise significance of these changes remains to be determined, including which of these changes are contraindications to liver transplantation. These findings may also have implications in the non-transplant setting as changes ascribed to specific etiologies for liver disease might include changes occurring in apparently healthy individuals.
Tran
Tram T
TT
Department of Medicine/Gastroenterology, Cedars Sinai Medical Center, Geffen UCLA School of Medicine, Los Angeles, California 90048, USA. TranT@cshs.org
Changsri
Chanikarn
C
Shackleton
C R
CR
Poordad
Fred F
FF
Nissen
Nicholas N
NN
Colquhoun
Steven
S
Geller
Stephen A
SA
Vierling
John M
JM
Martin
Paul
P
D000328:Adult; D000368:Aged; D001706:Biopsy; D015992:Body Mass Index; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000473:pathology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors