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Updated: Jul 7, 2026

Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
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Successful algorithm for selective liver biopsy in the right hepatic lobe live donor (RHLD).

M A Simpson1, J E Verbesey, U Khettry

  • 1Department of Hepatobiliary Surgery and Liver Transplantation, Lahey Clinic, Burlington, MA, USA. mary.a.simpson@lahey.org

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|February 12, 2008
PubMed
Summary

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Routine liver biopsy for live liver donors is unnecessary. A selective approach, based on specific criteria, identifies donors safely and avoids complications in most potential candidates.

Area of Science:

  • Hepatology
  • Transplantation Surgery
  • Medical Diagnostics

Background:

  • Liver biopsy is used to assess donor safety in living donor liver transplantation.
  • The necessity of routine predonation liver biopsy for right hepatic lobe live donors (RHLD) is debated.

Purpose of the Study:

  • To evaluate the safety and efficacy of a selective liver biopsy algorithm for RHLD evaluation.
  • To determine if routine predonation liver biopsy is necessary for RHLD.

Main Methods:

  • A selective liver biopsy algorithm was developed based on risk factors.
  • 403 potential RHLD were evaluated between 1999 and 2007.
  • Liver biopsies were performed selectively based on algorithm criteria and routinely at the time of surgery for all donors.

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Last Updated: Jul 7, 2026

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Published on: August 8, 2025

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Main Results:

  • Only 21.5% of potential donors met criteria for selective biopsy.
  • Abnormal biopsies (macrosteatosis >10%) eliminated 15 potential donors.
  • The selective algorithm allowed 78% of potential donors to avoid biopsy and potential complications, with no significant liver pathology found in those not meeting criteria.

Conclusions:

  • A selective liver biopsy approach is safe and effective for RHLD evaluation.
  • Routine predonation liver biopsy is not necessary for RHLD.
  • Selective biopsy minimizes donor complications and resource utilization.