The importance of donor biopsy in living donor liver transplantati̇on donor and clinical experiences

Today, liver transplantation is the treatment of end-stage liver failure. Because insufficiency of cadaveric donor numbers, in our country like other Asian countries, living donor liver transplantation(LDLT) is frequently performed. One of the most important steps of LDLT is donor safety. The most accurate information about donor liver is provided by liver biopsy. Two different views are available in the literature on liver biopsy, which is an invasive test in selecting healthy liver donors. One of the opinions suggests a routinely biopsy from each donor candidate, while the other recommends biopsy only from selected donor candidates who have suspicious findings in other investigations. In this study, it is aimed to investigate the necessity of liver biopsy by retrospective analysis of data of donor candidates routinely obtained liver biopsy in our clinic. In this study, 477 of the 481 donor candidates were taken into consideration who applied to the Polyclinic of the Akdeniz University Organ Transplant Institute between 01. January 2013- 01. July 2017. 4 candidates were excluded from the study because the information coldn't be reached. The examinations for preperation of donor canditates evaluated retrospectively. Data were analyzed with using Fisher's Exact test, Pearson Chi-Square test, Kolmogorov-Smirnov test, Independent samples t test, Kruskal Wallis test, Bonferroni-Dunn procedure and one-way difference Z test. The mean age of the donor candidates was 34.16 (18-62), 65% were male and 35% were female. Liver biopsies were performed to 209 donor candidates. 24 of 209 donor candidates were rejected after biopsy results. No statistically significant correlation was found between biopsy and the examinations before biopsy. 8 of the 24 rejected patients had no abnormal findings that required biopsy on previous examinations. The odds ratio was statistically significant compared to the one-way difference Z test (p <0.001). Biopsy results and ultrasound showed a significant correlation with fat rates. Routine biopsy has been shown to be necessary to provide donor safety. We believe that routine hepatic biopsy should be performed in centers that do not have advanced imaging methods such as our clinic.