Safety and Utility of Transjugular Liver Biopsy in Hematopoietic Stem Cell Transplant Recipients

Kis, Béla; Pamarthi, Vishwan; Fan, Chenguang; Rabkin, Dmitry J.; Baum, Richard A.

doi:10.1016/j.jvir.2012.09.011

Cited by 30 publications

(17 citation statements)

References 20 publications

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“…Because of the potential complications of hepatic biopsy in thrombocytopenic patients (i.e., hemorrhage, hemobilia, shock), the possibility of a histologic diagnosis of VOD/SOS is quite limited to well-trained centers with dedicated multidisciplinary team and cannot be considered a routine practice. Transjugular biopsy can limit the risk of bleeding and allow the measurement of the hepatic venous pressure gradient (HVPG), although the risk of unreadable specimens can be accounted (57). Hepatic venous pressure gradient is the hallmark of PH: its measurement is a very specific tool for VOD/SOS diagnosis, and values >10 mm Hg predict VOD/SOS with good level of accuracy and specificity (58).…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Diagnosis and Treatment of VOD/SOS After Allogeneic Hematopoietic Stem Cell Transplantation

et al. 2020

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Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome (SOS) is a rare complication characterized by hepatomegaly, right-upper quadrant pain, jaundice, and ascites, occurring after high-dose chemotherapy, hematopoietic stem cell transplantation (HSCT) and, less commonly, other conditions. We review pathogenesis, clinical appearance and diagnostic criteria, risk factors, prophylaxis, and treatment of the VOD occurring post-HSCT. The injury of the sinusoidal endothelial cells with loss of wall integrity and sinusoidal obstruction is the basis of development of postsinusoidal portal hypertension responsible for clinical syndrome. Risk factors associated with the onset of VOD and diagnostic tools have been recently updated both in the pediatric and adult settings and here are reported. Treatment includes supportive care, intensive management, and specific drug therapy with defibrotide. Because of its severity, particularly in VOD with associated multiorgan disease, prophylaxis approaches are under investigation. During the last years, decreased mortality associated to VOD/SOS has been reported being it attributable to a better intensive and multidisciplinary approach.

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Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Diagnosis and Treatment of VOD/SOS After Allogeneic Hematopoietic Stem Cell Transplantation

et al. 2020

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“…Schwan-Ganz catheter was used to measure free and wedged hepatic venous pressure at the midpart of right hepatic vein using multichannel monitor. Finally, TJLB was performed with LABS-100 (Liver Access Biopsy Set, Cook, Bloomington, USA) 6 which comprised 19G biopsy needle with 60 cm length, fixed throw of 20 mm, and stiff sheath through which the biopsy gun passes. Middle hepatic vein was accessed in only one case where a fragmented and small piece of tissue was obtained through the right hepatic venous approach due to the presence of significant right lobe atrophy.…”

Section: Methodsmentioning

confidence: 99%

Yield and Safety of Transjugular Versus Percutaneous Liver Biopsies in Suspected Cases of Diffuse Liver Disease and Correlation of Yield of Transjugular Liver Biopsy with Hepatic Venous Pressure Gradient

Dey¹,

Das

Chatterjee

et al. 2020

Journal of Gastrointestinal and Abdominal Radiology

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Background Liver biopsy is indicated in both diagnosis and prognosis of diffuse liver diseases. Conventionally, percutaneous liver biopsy (PLB) is used, as it is easily available, affordable and has a shorter procedure time, whereas transjugular liver biopsy (TJLB) is used in the setting of ascites and coagulopathy. Our aim is to evaluate the diagnostic yield of TJLB in comparison to PLB with tract embolization. Our secondary aims were to evaluate whether there is any difference in rate of major and minor complications between the two procedures and evaluate whether there is any correlation between diagnostic yield of TJLB and hepatic venous pressure gradient (HVPG). Methods In this retrospective study, we included a total of consecutive 123 patients who underwent liver biopsy through percutaneous (n = 97) and transjugular route (n = 26). We compared the yield of the specimen based on the number of complete portal tracts (CPT). Results There was no significant difference between mean CPT in TJLB and PLB specimens (mean CPT of TJLB and PLB were 10.9 ± 2.7 and 11.6 ±2.5, respectively [p = 0.566]). There was a moderate but significant negative correlation between the total number of CPT and HVPG in the TJLB group (Spearman’s rho − 0.58) (p = 0.002). There was no statistically significant difference in minor complication between the two procedures. Only one patient who underwent PLB developed major complication and none of TLJB procedure had any major complication. Conclusion Yield of tissue and complication rates are comparable in TJLB and PLB groups. Yield of tissue in TJLB have intermediate but significant negative correlation with HVPG.

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“…Transjugular liver biopsy (TJLB) is a safe procedure with a major complication rate of 0.6% and a minor complication rate of 6.5%. 7,33,34 Complication rates do not correlate with the number of samples taken. 35 Complications may include hemoperitoneum (0.2%) due to perforation of Glisson's capsule, arrhythmia, and transitory abdominal pain.…”

Section: Complicationsmentioning

confidence: 98%

Liver Biopsy

Attaya

Thabet

2018

Dig Dis Interv

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Liver biopsies are among the most common procedures performed by the interventional radiologist. Liver biopsies may be performed through the percutaneous or transjugular approaches. Ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) may be used for imaging guidance. Transjugular liver biopsies are generally reserved for specific circumstances in which the percutaneous method is associated with increased risk to the patient, such as coagulopathy, or when portal pressure measurements are desired. In addition, endobiliary biopsy through percutaneous transhepatic tracts may be an important means of assessing biliary strictures when the endoscopic route is impossible. This article serves as a general review of the multiple diagnostic hepatic interventions that may be performed by the interventional radiologist.

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Safety and Utility of Transjugular Liver Biopsy in Hematopoietic Stem Cell Transplant Recipients

Cited by 30 publications

References 20 publications

Diagnosis and Treatment of VOD/SOS After Allogeneic Hematopoietic Stem Cell Transplantation

Diagnosis and Treatment of VOD/SOS After Allogeneic Hematopoietic Stem Cell Transplantation

Yield and Safety of Transjugular Versus Percutaneous Liver Biopsies in Suspected Cases of Diffuse Liver Disease and Correlation of Yield of Transjugular Liver Biopsy with Hepatic Venous Pressure Gradient

Liver Biopsy

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