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All retrieval surgeons of the National Organ Retrieval Service perform an extensive examination of the abdomen and the chest at time of retrieval in order to exclude the presence of malignancies, as it would represent contraindications to organ donation.

Therefore, during the organ retrieval operation it may be possible to observe unexpected and undiagnosed lesions in the donor. The lesions can present themselves as “lumps” or “growth” that were not causing any form of symptoms in the donor. More importantly those lesions may not have never investigated.

In order to proceed with safe transplantation it is of paramount importance to evaluate any abnormality encountered with a biopsy. This consist of taking a sample off the lesion and being urgently processed for examination by a Pathologist. The sample may be “fixed” in a special solution to preserve the sample or sent as “frozen” section. The sample is then prepared for examination under the microscope.

The urgent report of the pathologist will then be made available to the NORS Team and transplant centres.

Urgent biopsies may be performed also for assessing organ quality. When organs are retrieved from certain categories of donors, such as elderly or with complex medical history (eg diabetes, hypertension, alcohol abuse), it may be necessary to evaluate the quality of the specific organ; mostly kidneys and livers may be biopsied. These biopsies generally take place at the transplant centres and are aimed to confirm the good quality of the organ and counselling the recipient accordingly.

It is not uncommon performing these biopsies as with progressive ageing of the population and increasing rate of donation, suspicious lesions are encountered more often. Finally, biopsy may be taken for research purpose only after adequate consent being taken.

ODT is currently supporting a number of projects aimed to ameliorate the histopathology service nationally for ensuring a safe and high quality transplant practice.

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