Complications of percutaneous liver biopsy in children

Cohen, Mitchell B.; A-Kader, H. Hesham; Lambers, Donna S.; Heubi, James E.

doi:10.1016/0016-5085(92)90112-c

Cited by 104 publications

(75 citation statements)

References 11 publications

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“…Unfortunately, both biological tests and imaging techniques are often poorly sensitive and not specific in transplant patients. Finally, biopsy represents a diagnostic alternative, but it is not free of further complications [4][5][6][7][8]. 18 F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) is a noninvasive imaging tool with high diagnostic accuracy and therapeutic impact in oncological clinical practice [9,10].…”

Section: Introductionmentioning

confidence: 99%

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

Muller

Kessler

Caillard

et al. 2016

Nucl Med Mol Imaging

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Purpose Infection and malignancy represent two common complications after solid organ transplantation, which are often characterized by poorly specific clinical symptomatology. Herein, we have evaluated the role of 18 F-fluoro-2-deoxy-Dglucose (FDG) positron emission tomography/computed tomography (PET/CT) in this clinical setting. Methods Fifty-eight consecutive patients who underwent FDG PET/CT after kidney, lung or heart transplantation were included in this retrospective analysis. Twelve patients underwent FDG PET/CT to strengthen or confirm a diagnostic suspicion of malignancies. The remaining 46 patients presented with unexplained inflammatory syndrome, fever of unknown origin (FUO), CMV or EBV seroconversion during post-transplant follow-up without conclusive conventional imaging. FDG PET/CT results were compared to histology or to the finding obtained during a clinical/imaging follow-up period of at least 6 months after PET/CT study. Results Positive FDG PET/CT results were obtained in 18 (31 %) patients. In the remaining 40 (69 %) cases, FDG PET/CT was negative, showing exclusively a physiological radiotracer distribution. On the basis of a patient-based analysis, FDG PET/CT's sensitivity, specificity, PPV and NPV were respectively 78 %, 90 %, 78 % and 90 %, with a global accuracy of 86 %. FDG PET/CT was true positive in 14 patients with bacterial pneumonias (n = 4), pulmonary fungal infection (n = 1), histoplasmosis (n = 1), cutaneous abscess (n = 1), inflammatory disorder (sacroiliitis) (n = 1), lymphoma (n = 3) and NSCLC (n = 3). On the other hand, FDG PET/CT failed to detect lung bronchoalveolar adenocarcinoma, septicemia, endocarditis and graft-versus-host disease (GVHD), respectively, in four patients. FDG PET/CT contributed to adjusting the patient therapeutic strategy in 40 % of cases. Conclusions FDG PET/CT emerges as a valuable technique to manage complications in the post-transplantation period. FDG PET/CT should be considered in patients with severe unexplained inflammatory syndrome or FUO and inconclusive conventional imaging or to discriminate active from silent lesions previously detected by conventional imaging particularly when malignancy is suspected.

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Section: Introductionmentioning

confidence: 99%

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

Muller

Kessler

Caillard

et al. 2016

Nucl Med Mol Imaging

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“…For example, bleeding is a major complication following conventional percutaneous liver biopsy, particularly when patients are thrombocytopenic or coagulopathic. 17,18 In a retrospective analysis of 87 patients who had undergone allogeneic BMT, three out of 13 patients with platelet counts less than 60 000/mm 3 suffered from a fatal hemorrhage. Two of the three patients who bled had an additional complicating factor, one with disseminated intravascular coagulopathy and the other with a small liver laceration.…”

Section: Discussionmentioning

confidence: 99%

The use of laparoscopic liver biopsies in pediatric patients with hepatic dysfunction following allogeneic hematopoietic stem cell transplantation

Choi

Islam

Greenson

et al. 2005

Bone Marrow Transplant

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Summary:Hepatic dysfunction following hematopoietic stem cell transplantation (HSCT) is common, but making the correct diagnosis can be challenging. Liver biopsies can serve as an important diagnostic tool when the etiology cannot be clearly determined by laboratory data, physical examination, and imaging studies. We reviewed 12 consecutive pediatric patients (seven males, five females, age 9-23 years) who received allogeneic HSCT and underwent a laparoscopicguided liver biopsy for hepatic dysfunction of unknown etiology from 1998 to 2005. Biopsies were performed using a single-port technique with a 16 or 18 gauge, spring-loaded biopsy gun. The time from HSCT to biopsy ranged from 31 days to 821 days (median 92 days). No intra-or postoperative complications were observed. The initial clinical diagnosis was confirmed in seven patients, whereas the initial working diagnosis was inaccurate in the remaining five patients. Our results suggest that laparoscopic-guided liver biopsy is an informative and safe procedure in pediatric HSCT recipients; this approach helped delineate the true cause of hepatic dysfunction and changed our therapeutic approach in approximately 40% of the patients reviewed. While the safety record at our institution appears promising, a larger multi-institutional study would be necessary to more accurately describe the overall efficacy of this procedure in pediatric HSCT patients. Bone Marrow Transplantation (2005) 36, 891-896.

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“…Obtaining hepatic tissue in BMT patients for histological assessment using Menghini, Tru-Cut or Jamshidi cutting needle (outer diameter from 1.8 to 2.0 mm) involves risk of bleeding and death. 7,8 We used a smaller cutting needle (1.2 mm, 18 G) with automatic aspiration under direct US guidance for the study of late post-BMT liver dysfunction. The procedure was performed by hematologists trained in ultrasonography and in USguided needle biopsy.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided fine needle cutting biopsy for the characterization of diffuse liver diseases in bone marrow transplant patients

Picardi

Rosa

Muretto

et al. 1998

Bone Marrow Transplant

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Summary:Liver disease is a frequent complication in bone marrow transplant recipients and may occur early or late in the post-transplant period. Using ultrasound-guided fine needle (1.2 mm, 18 G) cutting biopsy, we studied six patients with undefined late post-BMT liver disease. No procedure-related complications occurred and all liver biopsies were informative, leading to changes in therapeutic approach. In our small series, the most frequent cause of hepatic damage was drug toxicity. US-guided fine needle cutting biopsy is a useful and easy tool for the work-up of unexplained post-BMT liver disease.

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Complications of percutaneous liver biopsy in children

Cited by 104 publications

References 11 publications

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

18F-FDG PET/CT for the Diagnosis of Malignant and Infectious Complications After Solid Organ Transplantation

The use of laparoscopic liver biopsies in pediatric patients with hepatic dysfunction following allogeneic hematopoietic stem cell transplantation

Ultrasound-guided fine needle cutting biopsy for the characterization of diffuse liver diseases in bone marrow transplant patients

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