Liver Biopsy in Living-Related Liver Transplant Recipients?
Liver Biopsy in Living-Related Liver Transplant Recipients?
What are the indications for liver biopsy in the recipient of a living-related liver transplantation? Are there fixed time intervals at which liver biopsy should be done?
Adel Al-Ansary, MD
In most transplantation centers, including ours, the recipients of living-related liver transplantation are treated just like cadaveric liver transplant recipients. In that case, some centers do routine or protocol liver biopsies after the transplantation, especially in those recipients who had hepatitis C virus-related liver disease. The interval varies center to center; some perform biopsies more frequently than others. Most do at least 1 protocol biopsy per year in HCV disease-related recipients.
A very few centers do protocol biopsies on all living-related liver transplant recipients at 6- to 12-month intervals. All centers do biopsies when indicated, meaning in patients with abnormal liver enzymes levels. On the other hand, many centers, including ours, obtain imaging studies (either CT or MRI) on all recipients of living-related liver transplantation to evaluate the rate of liver regeneration. The frequency varies, but most centers do scans at 1, 3, 6, and 12 months.
The National Institutes of Health Living Donor Liver Transplantation cohort study (The University of North Carolina is one of 9 centers selected to participate) will include a liver biopsy protocol. This study is still in the planning phase.
What are the indications for liver biopsy in the recipient of a living-related liver transplantation? Are there fixed time intervals at which liver biopsy should be done?
Adel Al-Ansary, MD
In most transplantation centers, including ours, the recipients of living-related liver transplantation are treated just like cadaveric liver transplant recipients. In that case, some centers do routine or protocol liver biopsies after the transplantation, especially in those recipients who had hepatitis C virus-related liver disease. The interval varies center to center; some perform biopsies more frequently than others. Most do at least 1 protocol biopsy per year in HCV disease-related recipients.
A very few centers do protocol biopsies on all living-related liver transplant recipients at 6- to 12-month intervals. All centers do biopsies when indicated, meaning in patients with abnormal liver enzymes levels. On the other hand, many centers, including ours, obtain imaging studies (either CT or MRI) on all recipients of living-related liver transplantation to evaluate the rate of liver regeneration. The frequency varies, but most centers do scans at 1, 3, 6, and 12 months.
The National Institutes of Health Living Donor Liver Transplantation cohort study (The University of North Carolina is one of 9 centers selected to participate) will include a liver biopsy protocol. This study is still in the planning phase.
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