Judith Stift1, Georg Semmler2, Cita Walzel3, Mattias Mandorfer4, Remy Schwarzer5, Philipp Schwabl6, Rafael Paternostro7, Bernhard Scheiner8, Katharina Wöran9, Matthias Pinter10, Albert Friedrich Stättermayer11, Michael Trauner12, Markus Peck-Radosavljevic13, Arnulf Ferlitsch14, Thomas Reiberger15. 1. Department of Pathology, Medical University of Vienna, Vienna, Austria. Electronic address: judith.stift@meduniwien.ac.at. 2. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: georg.semmler@meduniwien.ac.at. 3. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: cwalzel@gmx.at. 4. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: mattias.mandorfer@meduniwien.ac.at. 5. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: remy.schwarzer@meduniwien.ac.at. 6. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: philipp.schwabl@meduniwien.ac.at. 7. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: rafael.paternostro@meduniwien.ac.at. 8. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: bernhard.scheiner@meduniwien.ac.at. 9. Department of Pathology, Medical University of Vienna, Vienna, Austria. Electronic address: katharina.woeran@meduniwien.ac.at. 10. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: matthias.pinter@meduniwien.ac.at. 11. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. Electronic address: albertfriedrich.staettermayer@meduniwien.ac.at. 12. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. 13. Department of Gastroenterology & Hepatology, Endocrinology and Nephrology, Klinikum Klagenfurt, Klagenfurt, Austria; Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. Electronic address: markus@peck.at. 14. Department of Internal Medicine I,Hospital of St. John of God, Vienna, Austria; Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. Electronic address: arnulf.ferlitsch@meduniwien.ac.at. 15. Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria. Electronic address: thomas.reiberger@meduniwien.ac.at.
Abstract
BACKGROUND: Transjugular liver biopsy (TJLB) represents an alternative to percutaneous liver biopsy especially in patients with impaired coagulation and ascites. AIMS: To describe safety and diagnostic yield of aspiration TJLB performed by hepatologists experienced in hepatic venous pressure gradient (HVPG) measurements. METHODS: 445 TJLB of 399 patients between 01/2007-12/2016 were retrospectively assessed. RESULTS: Histological diagnosis was obtained in 423 (95.1%) biopsies - including 11 (100%) patients with acute liver failure and 34 (97.1%) patients after liver transplantation. A median number of 5 portal tracts (interquartile range:2-9) was obtained. HVPG negatively correlated with sample length (Spearman ρ = -0.310; p < 0.001) and number of portal tracts (ρ = -0.212; p < 0.001). Among n = 151 patients with unknown etiology of liver disease, etiology was successfully identified on liver histology in 126 patients (83.4%). Complications occurred in 28 biopsies (6.3%) including 25 (5.6%) minor and 3 (0.7%) major complications. No deaths due to TJLB were observed. Neither the presence of ascites (6.6% complications) nor of coagulopathy (platelets<50G/L and/or prothrombin time<50%; 4.8% complications) increased the risk for complications. CONCLUSIONS: TJLB performed by hepatologists experienced in HVPG measurements is safe - even in patients with ascites or coagulopathy. TJLB has good diagnostic value for histological evaluation of liver disease and acute liver failure.
BACKGROUND: Transjugular liver biopsy (TJLB) represents an alternative to percutaneous liver biopsy especially in patients with impaired coagulation and ascites. AIMS: To describe safety and diagnostic yield of aspiration TJLB performed by hepatologists experienced in hepatic venous pressure gradient (HVPG) measurements. METHODS: 445 TJLB of 399 patients between 01/2007-12/2016 were retrospectively assessed. RESULTS: Histological diagnosis was obtained in 423 (95.1%) biopsies - including 11 (100%) patients with acute liver failure and 34 (97.1%) patients after liver transplantation. A median number of 5 portal tracts (interquartile range:2-9) was obtained. HVPG negatively correlated with sample length (Spearman ρ = -0.310; p < 0.001) and number of portal tracts (ρ = -0.212; p < 0.001). Among n = 151 patients with unknown etiology of liver disease, etiology was successfully identified on liver histology in 126 patients (83.4%). Complications occurred in 28 biopsies (6.3%) including 25 (5.6%) minor and 3 (0.7%) major complications. No deaths due to TJLB were observed. Neither the presence of ascites (6.6% complications) nor of coagulopathy (platelets<50G/L and/or prothrombin time<50%; 4.8% complications) increased the risk for complications. CONCLUSIONS: TJLB performed by hepatologists experienced in HVPG measurements is safe - even in patients with ascites or coagulopathy. TJLB has good diagnostic value for histological evaluation of liver disease and acute liver failure.
Authors: Georg Semmler; Bernhard Scheiner; Philipp Schwabl; Theresa Bucsics; Rafael Paternostro; David Chromy; Albert Friedrich Stättermayer; Michael Trauner; Mattias Mandorfer; Arnulf Ferlitsch; Thomas Reiberger Journal: PLoS One Date: 2019-11-06 Impact factor: 3.240
Authors: Lorenz Balcar; Georg Semmler; Katharina Pomej; Benedikt Simbrunner; David Bauer; Lukas Hartl; Mathias Jachs; Rafael Paternostro; Theresa Bucsics; Matthias Pinter; Michael Trauner; Mattias Mandorfer; Thomas Reiberger; Bernhard Scheiner Journal: United European Gastroenterol J Date: 2021-05 Impact factor: 4.623