Percutaneous Liver Biopsy Complications in Patients with Chronic Renal Failure

Mete Özdoğan, MD, Division of Gastroenterology, Baskent University School of Medicine, 10. cadde No. 77, Bahcelievler 06490 Ankara (Turkey) pliance and cooperation during the procedure [2]. All patients received local anesthesia with 2% prilocaine before the procedure. Prothrombin time 3 s over the control, platelet count less than 75,000/mm3, fever, sepsis and severe ascites were regarded as absolute contraindications for biopsy, whereas hemoglobin, BUN and creatinine values that were out of the normal range, and mild to moderate ascites were not. After biopsy, patients were asked to remain supine on their bed for 4 h, and allowed to mobilize thereafter. Vital signs were checked every 15 min for the first 2 h after the biopsy, and then every 30 min for the next 2 h and as usual thereafter. Dear Sir, Percutaneous liver biopsy (PLB) is a valuable method in detecting hepatic diseases. The procedure is quite safe and may be considered as a routine diagnostic procedure in patients with suspected liver dis-ease[l], but the complications and risk factors of PLB have not been clearly demonstrated for chronic renal failure (CRF) patients. Since most of the patients with CRF are considered as candidates for renal transplantation, all CRF patients must be examined for hepatitis virus infection and its consequences, because posttransplant immunosuppressive drug therapy will worsen the course of hepatitis. We performed PLB, using the Tru-Cut biopsy needle (ABC, Monoject, Sherwood Medical, USA) in a consecutive series of 150 patients, 74 (49%) with CRF who were candidates for renal transplantation and 76 (51 %) without renal disease. Complications were prospectively recorded and compared between the two groups to find out the risk of PLB in patients with CRF. Demographic and clinical characteristics of the patients are summarized in table 1. All biopsies were done after the patients were hospitalized. Sixty percent (n = 95) of the biopsies were performed by a staff gas-troenterologist, 38% (n = 62) were performed by 2 senior residents in gastroenterology and a minority (2%, n = 3) of biopsies were performed by a radiologist using ultrasound guidance. The biopsy site was determined solely by physical