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Transjugular liver biopsy in patients with living donor liver transplantation: Comparison with percutaneous biopsy
Author(s) -
Kim Kyung Rae,
Ko GiYoung,
Sung KyuBo,
Yoon HyunKi,
Shin Ji Hoon,
Song HoYoung,
Ryu JeHo,
Hwang Shin,
Lee SungGyu,
Yu Eunsil
Publication year - 2008
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21448
Subject(s) - medicine , liver transplantation , contraindication , transplantation , biopsy , complication , surgery , liver biopsy , pathology , alternative medicine
Transjugular liver biopsy (TJLB) is an alternative method of pathological diagnosis in patients with an established contraindication to percutaneous biopsy. Between November 2005 and July 2007, 111 TJLBs were attempted in 67 patients and 95 percutaneous liver biopsies (PCLBs) were attempted in 51 patients with living donor liver transplantation suspected of having rejection. Indications of TJLB included classic contraindications to PCLB and a postoperative period of less than 30 days. TJLB was performed a mean of 111.1 ± 292.6 days after transplantation (range: 6–2478 days, median: 35 days), and PCLB was performed a mean of 534.7 ± 591.6 days after transplantation (range: 6–2555 days, median: 299 days). Technical success was 99.1% in TJLB and 100% in PCLB, and there was no significant difference between these 2 groups ( P = 0.354). A clinical suspicion of rejection was confirmed by histopathology in 38 (34.2%) of 111 TJLBs and 38 (40.0%) of 95 PCLBs. The overall complication rates related to the procedure were 1.8% (2/111) in TJLB and 5.3% (5/95) in PCLB. Although there was no significant difference in complication rates between TJLB and PCLB ( P = 0.172), the patients who underwent TJLB showed significantly higher incidence of ascites, coagulopathy, and thrombocytopenia, given its indication. TJLB seems to be a safe and effective procedure for pathological diagnosis of rejection in patients with living donor liver transplantation when there is a high risk of complication with PCLB. Liver Transpl 14:971–979, 2008. © 2008 AASLD.