The purpose of this retrospective study was to investigate the overall complication rate and diagnostic yield of transjugular liver biopsy, with particular focus on patients who underwent multiple biopsies during the study period, and those with severe coagulopathy. Materials: Data on 802 transjugular liver biopsies performed from January 2009 to August 2015 were reviewed to determine the diagnostic efficacy and incidence of major and minor complications in the three-day and one-month period following the transjugular liver biopsy procedure. These biopsies were performed in 638 patients (385 male, 253 female). Demographic information, biopsy indication, and laboratory values for each biopsy were also aggregated for analysis, with a particular focus on two subgroups of patients: those who underwent multiple biopsies during the study period, and those patients at low, moderate, or high risk of coagulopathy. Results: TJLB yielded diagnostic specimens in 97.4% (781/ 802) biopsy procedures, with an overall complication rate was 9.9% (79/802). Patients who underwent multiple biopsies were at 9.9% (27/274). When patients were stratified by platelet count, patients with platelets of 0-50 had a complication rate of 11.6% (10/86), while those with platelet counts of 51-100 had a rate of 13.6% (28/206). Patients with platelet counts of 101-200 experienced complications at a rate of 7.3% (23/313), those with platelets of 201-300 had a rate of 12.2% (18/147) and patients with platets of 301 or more had a rate of 15.0% (6/40). When grouped by INR, complication rates were 7.7% (11/143) for patients with an INR between 0-1, 10.8% (67/618) for INR of 1.1-2.0, and 19.0% for those with an INR of 2.1-3.0. No complications were observed in patients with an INR of 3.1 or more (n¼5). Conclusions: Transjugular liver biopsy is a well-tolerated procedure with a low incidence of complications and a high rate of technical success. The procedure does not have a significantly increased complication rate in patients who are severely coagulopathic (critically ill patients) or those who receive multiple biopsies.
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