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. 2022 Nov;28(11):1709-1715.
doi: 10.1002/lt.26510. Epub 2022 Jun 12.

Use of preprocurement biopsy in donation after circulatory death liver transplantation

Alexandra C Bolognese  1 , David P Foley  1 , Carrie J Sparks  2 , Adam K Schneider  2 , Anthony M D'Alessandro  1   2 , Nikole A Neidlinger  1   2
Affiliations

Use of preprocurement biopsy in donation after circulatory death liver transplantation

Alexandra C Bolognese et al. Liver Transpl. 2022 Nov.

Abstract

We perform routine preprocurement image-guided percutaneous liver biopsies on potential donation after circulatory death (DCD) liver donors. The purpose of this study was to examine the impact of preprocurement liver biopsy on the use of livers from DCD donors. We retrospectively reviewed demographics, liver histology, and disposition of DCD liver donors within a single organ procurement organization (OPO) who underwent preprocurement liver biopsy from January 2000 through December 2019. A total of 212 potential donors underwent prerecovery biopsy. No donors were lost as a result of complications of biopsy. Of these, 183 (86.3%) had acceptable biopsies: 146 (79.8%) were successfully transplanted and 37 (20.2%) were deemed not suitable for transplant. In contrast, of 120 DCD livers recovered with the intent to transplant that were not biopsied prior to recovery, 59 (49.2%) were successfully transplanted, and 61 (50.8%) were deemed not suitable for transplant. A total of 14 donors were ruled out for transplant based on prerecovery histology. Successfully transplanted livers that underwent preprocurement biopsy were more likely to come from donors aged older than 50 years or with body mass index more than 30 kg/m2 compared with successfully transplanted livers without a prerecovery biopsy. Biopsy excluded 6.6% of DCD donor livers for transplant prior to recovery and facilitated the successful recovery and transplant of two-thirds of potential DCD donor livers. Livers intended for transplant at the time of recovery that did not undergo preprocurement biopsy were more likely to not be recovered or to be discarded. Preprocurement biopsy provides additional histologic information prior to deploying resources and helps to identify usable livers that might otherwise be declined for transplant. Consideration of liver biopsy in this group benefits OPOs and transplant centers by maximizing organ use and optimizing resource deployment.

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Conflict of interest statement

Nothing to report.

Figures

FIGURE 1
FIGURE 1
Liver biopsy consultation report.
FIGURE 2
FIGURE 2
Outcomes of DCD donors considered for liver donation.
See this image and copyright information in PMC

Comment in

References

    1. Smith M, Dominguez‐Gil B, Greer DM, Manara AR, Souter MJ. Organ donation after circulatory death: current status and future potential. Intensive Care Med. 2019;45:310–21. - PubMed
    1. Croome KP, Taner CB. The changing landscapes in DCD liver transplantation. Curr Transplant Rep. 2020;7:1–11. - PMC - PubMed
    1. Foley DP, Fernandez LA, Leverson G, Anderson M, Mezrich J, Sollinger HW, et al. Biliary complications after liver transplantation from donation after cardiac death donors: an analysis of risk factors and long‐term outcomes from a single center. Ann Surg. 2011;253:817–25. - PMC - PubMed
    1. Schlegel A, Kalisvaart M, Scalera I, Laing RW, Mergental H, Mirza DF, et al. The UKDCD Risk Score: a new proposal to define futility in donation‐after‐circulatory‐death liver transplantation. J Hepatol. 2018;68:456–64. - PubMed
    1. Oliver JB, Marcus AF, Paster M, Nespral J, Bongu A, Dikdan G, et al. Organ procurement organization survey of practices and beliefs regarding prerecovery percutaneous liver biopsy in donation after neurologic determination of death. Transplantation. 2017;101:821–5. - PMC - PubMed