Table 4.
Evaluation protocol for potential right lobe liver donors
| Step 1 | First informed consent Clinical evaluation: history and physical examination (transplant coordinator) Laboratory: blood group; hematologic tests; chemistry 12; glucose tolerance test*; coagulation profile; protein C; anti-thrombin III; factor V, VII and VIII; C-reactive protein; thyroid function test (TSH, T3, T4); substances of abuse panel Serology: hepatitis A,B (surface Ag, core Ab, surface Ab) and C Imaging studies: chest radiograph (PA and lateral), abdominal ultrasound |
| Step 2 | Clinical evaluation (transplant hepatologist), psychological evaluation, discussion with donor advocate Laboratory: HLA typing, cross-match, alpha1-antitrypsin, transferrin, ferritin, tumor markers (AFP, CEA), urine sediment, pregnancy test Serology: CMV IgG and IgM, HSV, EBV IgG and IgM, VDRL test, HIV (PCR) Imaging studies: MRI with liver volume measurement, MRA, MRC Special studies: pulmonary function tests, ECG, echocardiography, stress test* Histology: liver biopsy |
| Step 3 | Imaging studies: celiac angiography with portal phase |
| Step 4 | Clinical evaluation: planning of surgical date and availability of ICU facilities Blood bank: autologous blood donation Second informed consent, blood transfusion consent |
Abbreviations: TSH, thyroid-stimulating hormone; T3, triiodothyronine; T4, thyroxine; Ag, antigen; Ab, antibody; PA, postero-anterior; AFP, alphafetoprotein; CEA, carcinoembryonic antigen; CMV, cytomegalovirus; IgG, immunoglobulin; HSV, herpes simplex virus; EBV, Ebstein-Barr virus; VDRL, Venereal Disease Research Laboratory; HIV, human immunodeficiency virus; PCR, polymerase chain reaction; MRI, magnetic resonance imaging; MRA, magnetic resonance angiography; MRC, magnetic resonance cholangiography; ECG, electrocardiogram; ICU, intensive care unit.
*
Only performed if indicated.