The Role of Time Zero Liver Biopsies Following Graft Reperfusion in Prediction of Early Graft Dysfunction in living Donor Liver Transplantation

Time zero biopsy may reflect hepatic post-reperfusion changes that can affect graft outcome in LDLT. Aim: to highlight the role of time-zero biopsies in predicting early graft dysfunction following Living Donor Liver Transplantation (LDLT).Patients & Methods: Between January 2017 and September 2018, Time zero biopsy was taken in 49 patients. The severity of the ischemia reperfusion injury (IRI) was graded upon the presence of neutrophilic infiltrate and hepatocyte necrosis. Patients were divided into two groups; positive IRI (moderate or severe changes) and negative IRI (nil or mild changes).Histopathological changes were correlated with graft outcomes. Results: Time-zero biopsies of 49 liver allografts revealed negative IRI (35, 71.4%) (Group 1) and positive IRI (14, 28.6%) (Group 2). Recipients with positive IRI group showed a significant rise in serum bilirubin, ALT, AST and INR on days 5, 7, 30 post transplantation. Fifty percent of the allografts with positive IRI had significant biochemical and hematological criteria suggestive of early graft dysfunction.

Time-zero biopsies could represent an important tool in predicting EGD in LDLT.