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 transplants, histological abnormalities that are undetectable by serological, biochemical and radiological methods might play an important role in outcomes.
Dr Tran and colleagues from California analyzed 70 liver biopsies as part of an evaluation of potential donor candidates.
|67% had an unexpected abnormality|
|Journal of Gastroenterology & Hepatology|
Of the 70 potential donor candidates who underwent liver biopsy for evaluation for living donor liver transplantation, 67% had an unexpected abnormality.
The researchers noted that steatosis was the most common abnormality in 40%.
A variety of other histopathological abnormalities were found including granulomas of unknown etiology in 7%.
The research team also found chronic Hepatitis, and a microabscess.
None of the histological abnormalities had been suspected despite extensive clinical, serological or radiological investigation.
Dr Tran's team concludes, “Among the 70 potential donor candidates for living donor liver transplantation, 34% had unremarkable liver biopsies.”
“The most common abnormality was steatosis.”
“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.”