Safety and Efficacy of Fluoroscopic versus Ultrasound Guidance for Core Liver Biopsies in Potential Living Related Liver Transplant Donors: Preliminary Results

PURPOSE To describe and evaluate the safety and efficacy of fluoroscopically guided percutaneous liver biopsies in comparison with ultrasound (US)–guided percutaneous liver biopsies in potential living related liver donors. MATERIALS AND METHODS Retrospective analysis of 133 consecutive preoperative workups of potential living related liver donors was performed. The subjects were treated from January 1999 through May 2002. Subjects were divided into those who underwent US-guided subcostal 18-gauge core liver biopsies (group I) and those who underwent fluoroscopically guided intercostal 18-gauge core liver biopsies (group II). Group II biopsies were performed in a manner similar to percutaneous transhepatic cholangiography. All samples obtained during the study period were reevaluated prospectively by a transplant pathologist blinded to guidance modality for sample adequacy (defined as ≥5 complete portal triads). Subjects were followed for 4 hours before discharge and afterward in the transplant clinic until donation. Subjects who did not donate organs were followed for at least 1 month. RESULTS One hundred thirty-three potential donors were evaluated (55 for group I, 78 for group II). Mean follow-up was 1.7 months, and 77% of subjects donated. The mean numbers of needle passes were 2.1 and 2.3 for groups I and II, respectively. No major complications were encountered, and all subjects were discharged in 4 hours. Incidences of minor complications were 3.6% (vasovagal reactions) and zero for groups I and II, respectively. Sample adequacy rates were 100% and 99% for groups I and II, respectively. One case (1.8%) in group I, although pathologically adequate, had additional renal tissue. CONCLUSION Fluoroscopically guided liver biopsy shows encouraging initial safety results and is as effective as US-guided liver biopsy in normal subjects.