The utility of recovery biopsies in determining donor suitability

Tissue recovery personnel often find themselves in a situation in which, upon donor physical assessment, they discover an unusual or suspicious skin or tissue lesion. Because of the concern about the possibility of recovering tissues from a donor who may have an occult malignancy or infection, the Recovery Team may elect not to recover. Otherwise they may continue with the recovery, documenting their concern on the physical assessment form. At the time of evaluation of donor suitability the Medical Director must determine what the lesion is. This is inherently difficult and sometimes has led to the discard of recovered tissues. In order to optimize the gift of donation and avoid unnecessary deferral or discard of tissues we instituted a recovery biopsy procedure several years ago. Between January, 2005 and March, 2010, 561 biopsies were performed. In 552 donors (98.4%) there was no negative effect on medical suitability. Nine donors (1.6%) were found unsuitable based on the biopsy results. The recovery biopsy has allowed Recovery Teams to better manage their time by quickly identifying and biopsying suspicious lesions without trying to make a determination of donor eligibility and possibly ruling ineligible a qualified donor. The recovery biopsy has allowed the Medical Directors to make suitability decisions to accept or reject based on diagnostic certainty.