Percutaneous liver biopsy before organ removal-Impact on organ allocation and costs in liver transplantation

• Published in: Chirurg 2021-01, Vol.92 (1), p.49-61
• Main Authors: Beltzer, Christian, Quante, Markus, Rheinberger, Myriam, Baba, Hideo Andreas, Saner, Fuat, Fend, Falko, Biet, Thomas, Königsrainer, Alfred, Nadalin, Silvio
• Format: Article
• Language: ger
• Subjects: Biopsy; Humans; Liver; Liver Transplantation; Tissue and Organ Procurement; Tissue Donors
• ISSN: 1433-0385
• DOI: 10.1007/s00104-020-01192-w

The value and safety of percutaneous liver biopsy (PLB) in brain-dead donors before organ removal and its impact on organ allocation and costs of liver transplantation (LT) in the Eurotransplant (ET) region is still a matter of ongoing debate. A PLB was performed in 36 brain-dead organ donors. The complication rate, ultrasonography findings, macroscopic evaluation and histological results of PLB and donor characteristics were analyzed. Additionally, a nationwide survey was conducted among 11 liver transplantation experts. The need for PLB and its impact on the liver allocation process were evaluated. Possible cost savings were calculated for different scenarios based on cost data provided by the German Organ Transplantation Foundation. No complications of PLB were observed. The survey revealed that the PLB has a substantial impact on the allocation of donor organs, especially in organs fulfilling extended donor criteria (EDC). The cost calculation revealed an enormous potential for cost savings due to an optimized organ allocation process and avoidance of futile organ procurement. The PLB is a safe procedure and has tremendous potential for the optimization of the organ allocation process before organ procurement by reducing the cold ischemia time, avoiding unnecessarily discarding donor organs and saving costs. These data emphasize the clinical relevance and impact of PLB on the organ allocation process.