title: Transjugular liver biopsy in patients with end-stage renal disease.
abstract: OBJECTIVE
  To assess the efficacy and safety of transjugular liver biopsy (TJLB) in patients with end-stage renal disease (ESRD) who are undergoing hemodialysis treatment.
  
  
  METHODS
  Forty-six consecutive patients with liver disease who were undergoing hemodialysis were included in this study. An 18-gauge Tru-cut transjugular needle with a 20-mm throw was used to obtain liver tissue. All procedures were performed under fluoroscopic guidance. A single pathologist reviewed the biopsy specimens and assessed the size of fragments, number of portal tracts, and adequacy of the specimens for histologic diagnosis. All complications were recorded. The results were compared with the outcomes of percutaneous liver biopsy carried out at our institution in 32 patients with ESRD.
  
  
  RESULTS
  TJLB and percutaneous biopsy techniques yielded adequate specimens for histologic diagnosis in all patients. The mean length of the largest fragments of tissue obtained via the transjugular and percutaneous routes were 16 mm +/- 4 and 14 mm +/- 3, respectively (P = NS). There were no major complications among patients who underwent TJLB. Percutaneous liver biopsy was complicated by hemorrhage in four of 32 patients (12%), three of whom required blood transfusion.
  
  
  CONCLUSIONS
  TJLB is an effective and safe technique to obtain liver tissue in patients with ESRD and is associated with a lower complication rate than percutaneous liver biopsy.
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Kuwait, P.O. Box 24923, Safat 13110, Kuwait. Adelaaa@hotmail.com
authors.forename: Adel
authors.initials: A
authors.lastname: Ahmad
authors.forename: Fuad
authors.initials: F
authors.lastname: Hasan
authors.forename: Suad
authors.initials: S
authors.lastname: Abdeen
authors.forename: Maharaj
authors.initials: M
authors.lastname: Sheikh
authors.forename: Jan
authors.initials: J
authors.lastname: Kodaj
authors.forename: Mangalathillam R
authors.initials: MR
authors.lastname: Nampoory
authors.forename: Kaivilayil V
authors.initials: KV
authors.lastname: Johny
authors.forename: Haifa
authors.initials: H
authors.lastname: Asker
authors.forename: Iqbal
authors.initials: I
authors.lastname: Siddique
authors.forename: Luqman
authors.initials: L
authors.lastname: Thalib
authors.forename: Basil
authors.initials: B
authors.lastname: Al-Nakib
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006470:Hemorrhage / Q000209:etiology; D006509:Hepatitis B / Q000473:pathology; D006526:Hepatitis C / Q000473:pathology; D006801:Humans; D007601:Jugular Veins; D007676:Kidney Failure, Chronic / Q000473:pathology* / Q000628:therapy; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D006435:Renal Dialysis; D012449:Safety