Pre-recovery Bedside Liver Biopsy in Brain Death Organ Donors

Inclusion Criteria: * Neurological death donors in whom brain death determination is imminent * First person or next of kin consent for research becomes available * High risk donor, as defined by the following criteria i) Known liver disease ii) Hepatitis BsAg, BcAb, B DNA, Hepatitis C Ab or Hepatitis C RNA positivity iii) Age \>= 50 iv) Any of the following risk factors for fatty liver disease a) BMI \>= 30 b) History of Type 2 Diabetes Mellitus c) Ultrasound, Computerized Tomography or other imaging modalities suggesting steatosis v) Any of the following risk factors for chronic liver disease 1. Greater than 2 drinks of alcohol daily currently or in their history 2. Current IV drug use 3. Ultrasound, Computerized Tomography or other imaging modalities suggesting cirrhosis Exclusion Criteria: * Donation after cardiac death donors * Live organ donors * No first person consent and next of kin decline research consent * Donors in whom it has been established the liver will not be shared * Donors in whom percutaneous liver biopsy has been performed within the past month for any indication and the biopsy results are available and considered reliable. * Donor with a contraindication to liver biopsy, including INR \> 2, PTT \> 75, Platelets \< 70,000, history of coagulopathy, current or recent use (within 7 days) of antiplatelet agent such as aspirin or Plavix, and hemodynamic instability defined as a MAP less than 65mmHg. * Inability to position donor appropriately for performance of PPB * Unavailability of pathology staff to analyze specimen in a timely manner