Utility of liver biopsy in bone marrow transplant patients

Prabhleen Chahal, Cynthia Levy, Mark R. Litzow, Keith D. Lindor

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background and Aim: Hepatic dysfunction is a common cause of morbidity and mortality in bone marrow transplant recipients. During the complex clinical management of these patients, liver biopsies may be obtained during evaluation of abnormal liver tests. The purpose of our study was to assess the safety and use of liver biopsy in this patient population. Methods: In total, 1700 bone marrow transplants were performed at our institution from June 1982 to December 2002. Data from patients who underwent liver biopsy after their transplant were reviewed once they were identified through a computerized medical index system. Impact of the histological diagnosis on subsequent patient management was obtained from clinical records. The histological diagnosis made by dedicated hepatopathologists was used as the 'gold standard' to assess the reliability of clinical diagnosis. Results: Sixty-one patients, comprising 39 males and 22 females, had a liver biopsy performed (27 transjugular, 29 percutaneous, four laparoscopic, one not specified). As a result of liver biopsy, management was changed in 37% of patients and included addition of medical therapy in 11 and cessation of therapy in five patients. Complications from the liver biopsy were observed in 15 (25%) patients and involved 10 cases of pain or bleeding at the biopsy site, four subcapsular hemorrhages, and one arrhythmia leading to death. Conclusion: Liver biopsy, although infrequently obtained during the assessment of hepatic dysfunction in the bone marrow transplant population, can serve as an important diagnostic tool with a significant impact on the clinical management of these patients. Although we observed a higher complication rate, the majority of them were minor.

Original languageEnglish (US)
Pages (from-to)222-225
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume23
Issue number2
DOIs
StatePublished - Feb 2008

Keywords

  • Bone marrow transplant
  • Hepatic dysfunction
  • Liver biopsy
  • Percutaneous liver biopsy
  • Transjugular liver biopsy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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