Liver biopsy in assessment of extended criteria donors

Joseph B. Oliver, Praveena Machineni, Advaith Bongu, Trusha Patel, Joseph Nespral, Carie Kadric, Michael J. Goldstein, Harvey Lerner, David Gee, Richard Hillbom, Lloyd Brown, Kenneth Washburn, Baburao Koneru

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

The safety and liver utilization with prerecovery liver biopsy (PLB) in extended criteria liver donors are unclear. We conducted a retrospective cohort study in 1323 brain death donors (PLB = 496) from 3 organ procurement organizations (OPOs). Outcomes were complications, preempted liver recovery (PLR), and liver transplantation (LT). Additional analyses included liver-only and propensity score–matched multiorgan donor subgroups. PLB donors were older (57 versus 53 years; P < 0.001). Hepatitis C antibody positivity (14.3% versus 9.6%, P = 0.01) and liver-only donors (42.6% versus 17.5%; P < 0.001) were more prevalent. The PLB cohort had fewer complications (31.9% versus 42.3%; P < 0.001). In the PLB cohort, PLR was significantly higher (odds ratio [OR], 3.45; 95% confidence interval [CI], 2.42-4.92) and LT lower (OR, 0.69; 95% CI, 0.52-0.91). In liver-only and propensity score–matched multiorgan donor subgroups, PLR was significantly higher (OR, 1.76; 95% CI, 1.06-2.94 and OR, 2.29; 95% CI, 1.37-3.82, respectively) without a decrease in LT (OR, 0.71; 95% CI, 0.43-1.18 and OR, 0.91; 95% CI, 0.63-1.33, respectively) in PLB subgroups. In conclusion, in extended criteria liver donors, PLB is safe and decreases futile liver recovery without decreasing LT. Increased use of PLB, especially in liver-only donors, is likely to save costs to OPOs and transplant centers and improve efficiencies in organ allocation. Liver Transplantation 24 182–191 2018 AASLD.

Original languageEnglish (US)
Pages (from-to)182-191
Number of pages10
JournalLiver Transplantation
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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    Oliver, J. B., Machineni, P., Bongu, A., Patel, T., Nespral, J., Kadric, C., Goldstein, M. J., Lerner, H., Gee, D., Hillbom, R., Brown, L., Washburn, K., & Koneru, B. (2018). Liver biopsy in assessment of extended criteria donors. Liver Transplantation, 24(2), 182-191. https://doi.org/10.1002/lt.24947