Pre-recovery Bedside Liver Biopsy in Brain Death Organ Donors

Inclusion Criteria:

- Neurological death donors in whom brain death determination is imminent

- First person or next of kin consent for research becomes available

- High risk donor, as defined by the following criteria i) Known liver disease ii)
Hepatitis BsAg, BcAb, B DNA, Hepatitis C Ab or Hepatitis C RNA positivity iii) Age >=
50 iv) Any of the following risk factors for fatty liver disease a) BMI >= 30 b)
History of Type 2 Diabetes Mellitus c) Ultrasound, Computerized Tomography or other
imaging modalities suggesting steatosis v) Any of the following risk
factors for chronic liver disease

1. Greater than 2 drinks of alcohol daily currently or in their history

2. Current IV drug use

3. Ultrasound, Computerized Tomography or other imaging modalities suggesting
cirrhosis

Exclusion Criteria:

- Donation after cardiac death donors

- Live organ donors

- No first person consent and next of kin decline research consent

- Donors in whom it has been established the liver will not be shared

- Donors in whom percutaneous liver biopsy has been performed within the past month for
any indication and the biopsy results are available and considered reliable.

- Donor with a contraindication to liver biopsy, including INR > 2, PTT > 75, Platelets
< 70,000, history of coagulopathy, current or recent use (within 7 days) of
antiplatelet agent such as aspirin or Plavix, and hemodynamic instability defined as
a MAP less than 65mmHg.

- Inability to position donor appropriately for performance of PPB

- Unavailability of pathology staff to analyze specimen in a timely manner