Same day outpatient transjugular liver biopsies in haemophilia.
Patients with haemophilia are at increased risk of hepatitis C infection because of prior transfusion of blood products. Virtually all haemophiliacs who received pooled blood products before the mid-1980s have been infected with hepatitis C. A liver biopsy is important to identify the extent of liver disease, and to help determine the necessity of interferon therapy. With factor replacement, in-hospital liver biopsy is safe. Thirty patients with haemophilia were evaluated for chronic hepatitis C infection. Eleven patients subsequently underwent successful transjugular liver biopsy in the outpatient setting after appropriate factor replacement. Mean +/- SD pre- and posthaemoglobin values were 15.8 +/- 0.79 and 14.4 +/- 0.71 g dL(-1) (P = ns). There was no significant change in heart rate, systolic or diastolic blood pressure during the monitoring period (P = ns) and no major complication was noted in perioperative follow-up. The mean length of the liver biopsy specimens was 1.7 +/- 0.3 cm, mean grade was 2 +/- 0.6 and mean stage was 2.3 +/- 1.2. Our experience demonstrates that outpatient transjugular liver biopsy can be safely performed in patients with haemophilia in the outpatient setting, avoiding the cost and need for hospital admission.
Saab
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Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. ssaab@mednet.ucla.edu
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Ibrahim
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Dong
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Marder
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Logan
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D000328:Adult; D000556:Ambulatory Surgical Procedures; D001706:Biopsy / Q000379:methods; D005164:Factor IX / Q000032:analysis; D005169:Factor VIII / Q000032:analysis / Q000627:therapeutic use; D006467:Hemophilia A; D019698:Hepatitis C, Chronic / Q000175:diagnosis*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control
D005169:Factor VIII; D005164:Factor IX