Introduction: Living donor liver transplantation has been increasing due to the growing discrepancy between the number of patients in waiting lists for liver transplant and the availability of deceased-donors. The evaluation of potential liver donors should ensure the safety of the surgical procedure for the donor. In addition to this, preoperative tests should identify donor grafts that pose risks for the recipient.  Liver biopsy is the gold standard for selecting optimal donors. Our aim in this study is to evaluate the results of preoperative liver biopsy of potential donors.
Materials and Methods: Between December 1988 and October  2017, we performed 580 LT procedures at our centers (age range, 6 mo – 64 y).  We evaluated the demographic features of 612  living related liver donor candidates that we performed liver biopsy between  January 2001-June 2017. The histological analyses were examined. Body mass index and gender were compared in predicting the degree of histologically determined steatosis.
Results: We performed liver biopsy in 612 liver donor candidates (328 male, 284 female) (age range 18-69 years). Among these candidates, 416 liver biopsy were reported as normal (68%); 196 liver biopsies had pathological findings (32%). Of 196 donors with pathological findings; 86 (44%) had fatty changes, 24 (12%) had portal inflammation, 86 (44%) had other pathological findings (like fibrosis, hepatitis, focal spotty necrosis). The mean BMI with steatosis  were much more higher than the mean BMI without steatosis (29.7± 3.6 vs 24.8 ± 4.2) ( p<.001). 25% of male and 15% of female donor candidates had steatosis.
Conclusion: The high rate of pathological findings in liver biopsy of donor candidates with healthy-appearing livers pointed the importance of  liver biopsy in preoperative evaluation of donors.