Transjugular liver biopsy in BMT.
With the aim of evaluating liver disturbances after BMT in 76 patients, the hepatic venous pressure gradient was measured and a transvenous liver biopsy was performed through the jugular vein. Catheterization was successful in 71 patients (93%). In 11 cases the procedure was performed twice, yielding a total number of 82 studies. In five (6%) liver biopsies were non-evaluable. Complications were rare (7%), minor and reversible. As a result of this procedure, the diagnosis was modified in 45%, with both the diagnosis and treatment being modified in 30% of patients. Veno-occlusive disease (VOD) was histologically demonstrated in 15 out of 26 patients (58%) in whom this complication was suspected and in two out of 33 (6%) in whom it was not. Acute GVHD of the liver was confirmed in 15 out of the 35 patients (43%) in whom this complication was suspected and in four of 24 (17%) in whom it was not. The hepatic venous pressure gradient was significantly higher in VOD than in liver GVHD. Whereas 14/17 (82%) patients with VOD had a gradient pressure higher than 9 mmHg, no patient with GVHD had a gradient above this value. We conclude that transjugular liver biopsy is an effective, safe, and useful technique to evaluate BMT related liver dysfunction.
Carreras
E
E
Postgraduate School of Hematology Farreras Valenti, Hospital Clínic, Barcelona, Spain.
Grañena
A
A
Navasa
M
M
Bruguera
M
M
Marco
V
V
Sierra
J
J
Tassies
M D
MD
García-Pagán
J C
JC
Martí
J M
JM
Bosch
J
J
D001706:Biopsy / Q000379:methods*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000473:pathology*; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007601:Jugular Veins; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology