Introduction
The Indiana Organ Procurement Organization (IOPO) utilizes preoperative bedside liver biopsies in certain extended‐criteria donors (ECDs), obtained by the on‐site coordinator, to determine the utility of pursuing donation. This study reports the clinical and financial outcomes for this management strategy.
Methods
All bedside liver biopsies obtained in ECDs over a five‐yr period were reviewed. Study variables included the following: indication for biopsy, biopsy results, taking the case to the operating room, transplantation of the donor liver, and graft survival. All biopsies were processed at a single university center.
Results
There were 110 donors biopsied. Primary indications included the following: old age (29%), extensive/current alcohol abuse (26%), hepatitis C‐positive serology (21%), obesity (25%), and severely elevated liver function enzymes (18%). Biopsy results demonstrated a potentially transplantable liver in 73 cases (66%), all of whom were taken to the OR (while 37 ruled out for donation based upon liver biopsy [34%]). Of all biopsied livers, 49 ultimately were transplanted (45%). Intra‐operative decisions included the following: transplant 51/73 (70%), surgeon decision to exclude 20/73 (27%), nonuse due to finding of malignancy two (3%).
Conclusions
Bedside liver biopsy may be a valuable tool to determine the utility in pursuing donation in ECDs, particularly with liver‐only donors.