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Transjugular Liver Biopsy Following Left Lobe or Lateral Segment Transplantation in Pediatric Patients

  • Clinical Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy and safety of transjugular liver biopsy in pediatric patients with left lobe or lateral segment liver transplant.

Materials and Methods

This was a retrospective study of data from 104 transjugular liver biopsies (57 children) using an 18- or 19-G biopsy needle. Transjugular liver biopsy was selected due to coagulopathy and/or ascites in 56 (54%) procedures. The median patient age, body weight, and interval from liver transplantation were 56 months, 16 kg, and 2 months, respectively. Technical success was defined as adequate liver specimens yield determined by the operator at the time of procedure. Complications, the longest length of obtained liver specimens according to needle type, and adequacy for histological diagnosis were analyzed.

Result

Biopsy using a biopsy needle was successfully achieved in 103 procedures (99%). In one procedure, liver samples were obtained using biopsy forceps following unsuccessful attempts with a biopsy needle. Major complication occurred in one procedure following biopsies using both a biopsy needle and biopsy forceps. The patient received transfusion to manage decreased blood pressure and hemoglobin levels although post-biopsy venography did not show extravasation. The median longest length of liver specimens using 18-G (n = 63) and 19-G (n = 40) needles were 10 mm (range, 5–20) and 10 mm (range, 5–20), respectively (p = 0.704). Liver specimens were adequate for histological diagnosis in all procedures.

Conclusion

Transjugular liver biopsy using a biopsy needle appears to be a safe and effective method to obtain liver specimens for histological diagnosis in pediatric patients with left lobe or lateral segment liver transplant.

Level of Evidence

Level 4, case series.

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References

  1. Colapinto RF. Transjugular biopsy of the liver. Clin Gastroenterol. 1985;14(2):451–67.

    CAS  PubMed  Google Scholar 

  2. Gamble P, Colapinto RF, Stronell RD, Colman JC, Blendis L. Transjugular liver biopsy: a review of 461 biopsies. Radiology. 1985;157(3):589–93.

    Article  CAS  PubMed  Google Scholar 

  3. Kalambokis G, Manousou P, Vibhakorn S, Marelli L, Cholongitas E, Senzolo M, Patch D, Burroughs AK. Transjugular liver biopsy: indications, adequacy, quality of specimens, and complications—a systematic review. J Hepatol. 2007;47(2):284–94.

    Article  PubMed  Google Scholar 

  4. Cholongitas E, Quaglia A, Samonakis D, Senzolo M, Triantos C, Patch D, Leandro G, Dhillon AP, Burroughs AK. Transjugular liver biopsy: how good is it for accurate histological interpretation? Gut. 2006;55(12):1789–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Franchi-Abella S, Cahill AM, Barnacle AM, Pariente D, Roebuck DJ. Hepatobiliary intervention in children. Cardiovasc Intervent Radiol. 2014;37(1):37–54.

    Article  PubMed  Google Scholar 

  6. Kim KR, Ko GY, Sung KB, Yoon HK, Shin JH, Song HY, Ryu JH, Hwang S, Lee SG, Yu E. Transjugular liver biopsy in patients with living donor liver transplantation: comparison with percutaneous biopsy. Liver Transpl. 2008;14(7):971–9.

    Article  PubMed  Google Scholar 

  7. Miraglia R, Maruzzelli L, Minervini MI, Volpes R, Vizzini G, Gruttadauria S, Caruso S, Luca A, Gridelli B. Transjugular liver biopsy in liver transplant patients using an 18-gauge automated core biopsy needle. Eur J Radiol. 2011;80(3):e269–272.

    Article  PubMed  Google Scholar 

  8. Azoulay D, Raccuia JS, Roche B, Reynes M, Bismuth H. The value of early transjugular liver biopsy after liver transplantation. Transplantation. 1996;61(3):406–9.

    Article  CAS  PubMed  Google Scholar 

  9. Mentha G, Widmann JJ, Schneider PA, Huber O, Meyer P, Le Coultre C, Villiger A, Rohner A. Hepatic venography, manometric studies and transjugular liver biopsy in the follow-up of liver transplant patients. Transplant Proc. 1990;22(4):1519–20.

    CAS  PubMed  Google Scholar 

  10. Lee KA, Taylor A, Bartolome B, Fidelman N, Kolli KP, Kohi M, Kohlbrenner R, Laberge J, Lehrman E, Kerlan R, Jr.: Safety and Efficacy of Transjugular Liver Biopsy in Patients with Left Lobe-Only Liver Transplants. J Vasc Interv Radiol 2019.

  11. Miller MJ, Smith TP, Kuo PC, Hirasaki KK, Suhocki PV. Transjugular biopsy results in the transplanted liver: comparison of two surgical hepatic venous anastomotic configurations in 269 consecutive biopsies over a 14-year period. J Vasc Interv Radiol. 2010;21(4):508–14.

    Article  PubMed  Google Scholar 

  12. Miraglia R, Maruzzelli L, Spada M, Riva S, Luca A, Gridelli B. Transjugular liver biopsy in pediatric patients with left split liver transplantation and severe coagulation impairment. Pediatr Transplant. 2012;16(1):58–62.

    Article  PubMed  Google Scholar 

  13. Clark TW, McCann JW, Salsamendi J, Dowd MF, Hajdu CH. Optimizing needle direction during transjugular liver biopsy provides superior biopsy specimens. Cardiovasc Intervent Radiol. 2014;37(6):1540–5.

    Article  PubMed  Google Scholar 

  14. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40(8):1141–6.

    Article  CAS  PubMed  Google Scholar 

  15. Abujudeh H, Huggins R, Patel A. Emergency transjugular liver biopsies in post-liver-transplant patients: technical success and utility. Emerg Radiol. 2004;10(5):268–9.

    Article  CAS  PubMed  Google Scholar 

  16. Romero M, Banares R, Salcedo M, Alvarez E, Peligros I, Clemente G, Cos E. Diagnostic value of transjugular liver biopsy in liver transplant recipients. Gastroenterol Hepatol. 1999;22(10):493–6.

    CAS  PubMed  Google Scholar 

  17. Little AF, Zajko AB, Orons PD. Transjugular liver biopsy: a prospective study in 43 patients with the quick-core biopsy needle. J Vasc Interv Radiol. 1996;7(1):127–31.

    Article  CAS  PubMed  Google Scholar 

  18. Habdank K, Restrepo R, Ng V, Connolly BL, Temple MJ, Amaral J, Chait PG. Combined sonographic and fluoroscopic guidance during transjugular hepatic biopsies performed in children: a retrospective study of 74 biopsies. AJR Am J Roentgenol. 2003;180(5):1393–8.

    Article  PubMed  Google Scholar 

  19. Atar E, Ben Ari Z, Bachar GN, Amlinski Y, Neyman C, Knizhnik M, Litvin S, Schmilovitz-Weiss H, Shapiro R, Bruckhaimer E, et al. A comparison of transjugular and plugged-percutaneous liver biopsy in patients with contraindications to ordinary percutaneous liver biopsy and an "in-house" protocol for selecting the procedure of choice. Cardiovasc Intervent Radiol. 2010;33(3):560–4.

    Article  PubMed  Google Scholar 

  20. Vibhakorn S, Cholongitas E, Kalambokis G, Manousou P, Quaglia A, Marelli L, Senzolo M, Patch D, Dhillon A, Burroughs AK. A comparison of four- versus three-pass transjugular biopsy using a 19-G Tru-Cut needle and a randomized study using a cassette to prevent biopsy fragmentation. Cardiovasc Intervent Radiol. 2009;32(3):508–13.

    Article  PubMed  Google Scholar 

  21. Gonzalez-Tutor A, Garcia-Valtuille R, Cerezal L, Bustamante M. Transjugular biopsy of the liver with an automated device. Acta Radiol. 1998;39(6):686–9.

    Article  CAS  PubMed  Google Scholar 

  22. DiMichele DM, Mirani G, Wilfredo Canchis P, Trost DW, Talal AH. Transjugular liver biopsy is safe and diagnostic for patients with congenital bleeding disorders and hepatitis C infection. Haemophilia. 2003;9(5):613–8.

    Article  CAS  PubMed  Google Scholar 

  23. Li FQ, Ko GY, Sung KB, Gwon DI, Ko HK, Kim JW, Yu E. Transfemoral liver biopsy using a quick-core biopsy needle system in living donor liver transplantation recipients. Liver Transpl. 2014;20(10):1178–84.

    Article  PubMed  Google Scholar 

  24. Kawano Y, Mizuta K, Sanada Y, Urahashi T, Ihara Y, Okada N, Yamada N, Sasanuma H, Sakuma Y, Taniai N, et al. Complementary indicators for diagnosis of hepatic vein stenosis after pediatric living-donor liver transplantation. Transplant Proc. 2016;48(4):1156–61.

    Article  CAS  PubMed  Google Scholar 

  25. Tulin-Silver S, Obi C, Kothary N, Lungren MP. Comparison of transjugular liver biopsy and percutaneous liver biopsy with tract embolization in pediatric patients. J Pediatr Gastroenterol Nutr. 2018;67(2):180–4.

    Article  PubMed  Google Scholar 

  26. Lungren MP, Lindquester WS, Seidel FG, Kothary N, Monroe EJ, Shivaram G, Gill AE, Hawkins MC. Ultrasound-guided liver biopsy with gelatin sponge pledget tract embolization in infants weighing less than 10 kg. J Pediatr Gastroenterol Nutr. 2016;63(6):e147–e151151.

    Article  PubMed  Google Scholar 

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea

    Gi-Young Ko, Kyu-Bo Sung & Dong Il Gwon

  2. Department of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

    Doan-Khac-Viet Tran

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  1. Doan-Khac-Viet Tran
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  2. Gi-Young Ko
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  3. Kyu-Bo Sung
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  4. Dong Il Gwon
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Correspondence to Gi-Young Ko.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

This study has obtained IRB approval from Asan Medical Center Institutional Review Board, and the need for informed consent was waived.

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Consent for publication was obtained for every individual person’s data included in the study.

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Tran, DKV., Ko, GY., Sung, KB. et al. Transjugular Liver Biopsy Following Left Lobe or Lateral Segment Transplantation in Pediatric Patients. Cardiovasc Intervent Radiol 42, 1545–1550 (2019). https://doi.org/10.1007/s00270-019-02301-x

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  • DOI: https://doi.org/10.1007/s00270-019-02301-x

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