LIVING LIVER DONORS AND TECHNIQUES

S. Sevmis¹, S. Aktas¹, H. Karakayali¹, B. Demirhan², H. Selcuk³, M. Haberal^1
1General Surgery, Baskent University, Ankara/TURKEY, ²Pathology, Baskent University, Ankara/TURKEY, ³Gastroenterology, Baskent University, Ankara/TURKEY

Body: Introduction: There is no consensus on how to evaluate liver graft for liver transplantation. Many investigators think that blood tests combined with radiologic imaging of the liver are adequate for living-donor liver transplantation. In this article, we describe our experience with liver biopsy, which is one of the fundamental parts of our donor selection procedure. Methods: Since September 2001, 531 liver donors were evaluated in our center. Liver biopsy was performed as a final step of our donor evaluation protocol in 259 of these 531 liver donors. Results: Of the 259 specimen, 220 candidates were identified as suitable liver donors due to normal or acceptable histological findings (72 normal, 9 minimal fatty changes, 29 minimal hepatocellular injury, and 113 nonspecific changes). The remaining 39 (15%) specimens showed abnormal histologic findings: 7 exhibited chronic hepatitis, 1 cirrhosis, 12 severe hepatocellular injury, 4 diffuse hepatocellular ballooning, and 15 moderate and severe macro vesicular fatty changes (between 30% and 90%). These 39 potential donors were eliminated due to liver histology findings. Conclusion: Our data show that some living-related liver donors, appearing absolutely healthy, had biopsies with abnormal pathology results. 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. In our opinion, liver biopsy should be a fundamental element of routine living liver donor evaluation protocol.

Disclosure: All authors have declared no conflicts of interest.