Liver Biopsy in Liver Transplant Recipients

ABSTRACT

Liver biopsy has been used in the assessment of the nature and course of liver diseases and to monitor treatments. In nontransplanted patients, liver biopsies have been well described. Less has been written on the biopsies of transplanted livers. In the liver transplant population, liver biopsy remains the “gold standard” for the diagnosis of rejection. The transplanted liver has additional considerations that can make biopsy less routine and more challenging.

KEYWORDS

Liver biopsy - liver transplant - percutaneous liver biopsy - transjugular liver biopsy

REFERENCES

• 1 Hultcrantz R, Gabrielsson N. Patients with persistent elevation of aminotransferases: investigation with ultrasonography, radionuclide imaging and liver biopsy.  J Intern Med. 1993;  233 7-12
• 2 Colonna II J O, Brems J J, Goldstein L I et al.. The importance of percutaneous liver biopsy in the management of the liver transplant recipient.  Transplant Proc. 1988;  20(suppl 1) 682-684
• 3 Bubak M E, Porayko M K, Krom R AF, Wiesner R H. Complications of liver biopsy in liver transplant patients: increased sepsis associated with choledochojejunostomy.  Hepatology. 1991;  14 1063-1065
• 4 Neuberger J, Wilson P, Adams D. Protocol liver biopsies: the case in favour.  Transplant Proc. 1998;  30 1497-1499
• 5 General principles .In: Lee RG. Diagnostic Liver Pathology. St Louis; Mosby-Year Book 1994: 1-21
• 6 Bravo A, Sheth S G, Chopra S. Current concepts: liver biopsy.  N Engl J Med. 2001;  344 495-500
• 7 Vargas C, Jeffers L J, Bernstein D et al.. Diagnostic laparoscopy: a 5-year experience in a hepatology training program.  Am J Gastroenterol. 1995;  90 1258-1262
• 8 Vautier G, Scott B, Jenkins D. Liver biopsy: blind or guided?.  BMJ. 1994;  309 1455-1456
• 9 Pasha T, Gabriel S, Therneau T, Dickson E R, Lindor K D. Cost-effectiveness of ultrasound guided liver biopsy.  Hepatology. 1998;  27 1220-1226
• 10 Younossi Z M, Teran J C, Ganiats T G, Carey W D. Ultrasound-guided liver biopsy for parenchymal liver disease: an economic analysis.  Dig Dis Sci. 1998;  43 46-50
• 11 McGill D B, Rakela J, Zinsmeister A R, Ott B J. A 21-year experience with major hemorrhage after percutaneous liver biopsy.  Gastroenterology. 1990;  99 1396-1400
• 12 Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy: a multicentre retrospective study on 68,276 biopsies.  J Hepatol. 1986;  2 165-173
• 13 Bateson M C, Hopwood D, Duguid H L, Bouchier I A. A comparative trial of liver biopsy needles.  J Clin Pathol. 1980;  33 131-133
• 14 Colombo M, Del Ninno E, de Franchis R et al.. Ultrasound-assisted percutaneous liver biopsy: superiority of the Tru-Cut over the Menghini needle for diagnosis of cirrhosis.  Gastroenterology. 1988;  95 487-489
• 15 Jacobs W H, Goldberg S B. Statement on outpatient percutaneous liver biopsy.  Dig Dis Sci. 1989;  34 322-323
• 16 Janes C H, Lindor K D. Outcome of patients hospitalized for complications after outpatient liver biopsy.  Ann Intern Med. 1993;  118 96-98
• 17 Van Thiel D H, Gavaler J S, Wright H, Tzakis A. Liver biopsy: its safety and complications as seen at a liver transplant center.  Transplantation. 1993;  55 1087-1090
• 18 Reddy K R, Schiff E R. Complications of liver biopsy. In: Taylor MB Gastrointestinal Emergencies, 2nd ed. Baltimore; Williams & Wilkins 1997: 959-968
• 19 Lichtenstein D R, Kim D, Chopra S. Delayed massive hemobilia following percutaneous liver biopsy: treatment by embolotherapy.  Am J Gastroenterol. 1992;  87 1833-1838
• 20 Lebrec D, Goldfarb G, Degott C, Rueff B, Benhamou J P. Transvenous liver biopsy: an experience based on 1000 hepatic tissue samplings with this procedure.  Gastroenterology. 1982;  83 338-340
• 21 Snover D C, Freese D K, Sharp H L et al.. Liver allograft rejection: an analysis of the use of biopsy in determining the outcome of rejection.  Am J Surg Pathol. 1987;  11 1-10
• 22 Azouley D, Raccuia J S, Rache B, Reynes M, Bismuth H. The value of early transjugular liver biopsy after liver transplantation.  Transplantation. 1996;  61 406-409
• 23 Lerut J P, Goffette P, Molle G et al.. Transjugular intrahepatic portosystemic shunt after adult liver transplantation; experience in eight patients.  Transplantation. 1999;  68 379-384
• 24 Lin B H, Van Ha T, Zeikus E et al.. Transjugular liver biopsy in patients with liver transplant and coagulopathies.  AJR Am J Roentgenol. 2001;  176(suppl) 60
• 25 McAfee J H, Keeffe E B, Lee R G, Rosch J. Transjugular liver biopsy.  Hepatology. 1992;  15 726-732
• 26 Brenard R, Horsmans Y, Rahier J, Druez P, Descamps C, Geubel A. Transjugular liver biopsy: an experience based on 500 procedures.  Acta Gastroenterol Belg. 1997;  60 138-141
• 27 Papatheodoridis G V, Patch D, Watkinson A, Tibballs J, Burroughs A K. Transjugular liver biopsy in the 1990s: a 2-year audit.  Aliment Pharmacol Ther. 1999;  13 603-608
• 28 Wallace M J, Narvios A, Lichtiger B et al.. Transjugular liver biopsy in patients with hematologic malignancy and severe thrombocytopenia.  J Vasc Interv Radiol. 2003;  14 323-327