Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Gastroenterology
Published in: BMC Gastroenterology 1/2023

Open Access 01-12-2023 | Research

Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality

Authors: Miao-Yang Chen, An-Yin Yang, Yi-Fan Hu, Yong-Feng Yang, Qing-Fang Xiong, Yan-Dan Zhong, Du-Xian Liu

Published in: BMC Gastroenterology | Issue 1/2023

Login to get access

Abstract

Background

Complications and diagnostic efficiency for liver biopsy are main concerns for clinicians. This study aimed to assess the safety and efficacy of transjugular liver biopsy (TJLB) compared with percutaneous liver biopsy (PLB) when patients had equal level of liver function and number of passes, using propensity score matching (PSM).

Methods

The clinical and pathological data of patients who received TJLB or PLB between January 2012 and October 2022 were collected. Matching factors included age, gender, cirrhosis, portal hypertension, liver function, creatinine, number of passes, hemodialysis, history of anti-coagulation and anti-platelet, and comorbidities. Coagulation indexes were not considered as matching factors due to different indications of the two techniques.

Results

2711 PLBs and 30 TJLBs were evaluated. By PSM, 75 patients (50 PLBs, 25 TJLBs) were matched. The complication rates for TJLB and PLB were 4.0% (1/25) and 10.0% (5/50) (P > 0.05). Two PLBs had hepatic hemorrhage, one of which required only close monitoring (Grade 1) and the other needed hemostasis and rehydration therapy (Grade 2). The other 3 cases presented with mild abdominal pain (Grade 1). And only one TJLB presented with mild pain. The median number of complete portal tracts were 6.0 and 10.0 for TJLBs and PLBs (P < 0.05). Moreover, the median length of sample for TJLBs and PLBs were 10.0 and 16.5 mm (P < 0.05). The diagnostic efficiency of hepatopathy of unknown etiology of TJLB versus PLB groups before and after matching were 96.4% vs. 94.1% and 95.7% vs. 93.2%, respectively (P > 0.05).

Conclusion

TJLB is an effective invasive diagnostic procedure that expands indications for liver biopsy with reliable diagnostic quality.
Literature
1.
Bissonnette J, Riescher-Tuczkiewicz A, Gigante E, Bourdin C, Boudaoud L, Soliman H, Durand F, Ronot M, Valla D, Vilgrain V, et al. Predicting bleeding after liver biopsy using comprehensive clinical and laboratory investigations: a prospective analysis of 302 procedures. J Thromb Haemost. 2022;20(12):2786–96.CrossRefPubMedPubMedCentral
2.
Chi H, Hansen BE, Tang WY, Schouten JN, Sprengers D, Taimr P, Janssen HL, de Knegt RJ. Multiple biopsy passes and the risk of complications of percutaneous liver biopsy. Eur J Gastroenterol Hepatol. 2017;29(1):36–41.CrossRefPubMed
3.
Khalifa A, Rockey DC. The utility of liver biopsy in 2020. Curr Opin Gastroenterol. 2020;36(3):184–91.CrossRefPubMed
4.
Neuberger J, Patel J, Caldwell H, Davies S, Hebditch V, Hollywood C, Hubscher S, Karkhanis S, Lester W, Roslund N, et al. Guidelines on the use of liver biopsy in clinical practice from the british Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology. Gut. 2020;69(8):1382–403.CrossRefPubMed
5.
Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American Association for the study of liver D: liver biopsy. Hepatology. 2009;49(3):1017–44.CrossRefPubMed
6.
De Gottardi A, Rautou PE, Schouten J, Rubbia-Brandt L, Leebeek F, Trebicka J, Murad SD, Vilgrain V, Hernandez-Gea V, Nery F, et al. Porto-sinusoidal vascular disease: proposal and description of a novel entity. Lancet Gastroenterol Hepatol. 2019;4(5):399–411.CrossRefPubMed
7.
de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Baveno VIIF. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959–74.CrossRefPubMed
8.
Terjung B, Lemnitzer I, Dumoulin FL, Effenberger W, Brackmann HH, Sauerbruch T, Spengler U. Bleeding complications after percutaneous liver biopsy. An analysis of risk factors. Digestion. 2003;67(3):138–45.CrossRefPubMed
9.
Dohan A, Guerrache Y, Dautry R, Boudiaf M, Ledref O, Sirol M, Soyer P. Major complications due to transjugular liver biopsy: incidence, management and outcome. Diagn Interv Imaging. 2015;96(6):571–7.CrossRefPubMed
10.
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.CrossRefPubMed
11.
Ble M, Procopet B, Miquel R, Hernandez-Gea V, Garcia-Pagan JC. Transjugular liver biopsy. Clin Liver Dis. 2014;18(4):767–78.CrossRefPubMed
12.
Sue MJ, Lee EW, Saab S, McWilliams JP, Durazo F, El-Kabany M, Kaldas F, Busuttil RW, Kee ST. Transjugular Liver Biopsy: safe even in patients with severe Coagulopathies and multiple biopsies. Clin Transl Gastroenterol. 2019;10(7):e00063.CrossRefPubMedPubMedCentral
13.
Stift J, Semmler G, Walzel C, Mandorfer M, Schwarzer R, Schwabl P, Paternostro R, Scheiner B, Woran K, Pinter M, et al. Transjugular aspiration liver biopsy performed by hepatologists trained in HVPG measurements is safe and provides important diagnostic information. Dig Liver Dis. 2019;51(8):1144–51.CrossRefPubMed
14.
15.
Coral GP, Antunes AD, Serafini AP, Araujo FB, Mattos AA. Liver biopsy: importance of Specimen size in the diagnosis and staging of chronic viral Hepatitis. Rev Inst Med Trop Sao Paulo. 2016;58:10.CrossRefPubMedPubMedCentral
16.
Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643–54. e641-649; quiz e639-640.CrossRefPubMed
17.
Metadata
Title
Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality
Authors
Miao-Yang Chen
An-Yin Yang
Yi-Fan Hu
Yong-Feng Yang
Qing-Fang Xiong
Yan-Dan Zhong
Du-Xian Liu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2023
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-023-02917-x

Other articles of this Issue 1/2023

BMC Gastroenterology 1/2023 Go to the issue

Research

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Research

Identification of inadequate responders to advanced therapy among commercially-insured adult patients with Crohn’s disease and ulcerative colitis in the United States

Research

Symptoms and symptom clusters in patients newly diagnosed with inflammatory bowel disease: results from the IBSEN III Study

Research article

Potential utility of a multi-component coagulation factor panel to calculate MELD scores and assess the risk of portal vein thrombosis in chronic liver disease

Research article

Establishment and evaluation of an early prediction model of hepatorenal syndrome in patients with decompensated hepatitis B cirrhosis

Research

Clinical characteristics and management of patients with nonalcoholic steatohepatitis in a real-world setting: analysis of the Ipsos NASH therapy monitor database
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits