title: Transjugular liver biopsy is a safe and effective intervention to guide management for patients with a congenital bleeding disorder infected with hepatitis C.
abstract: The prevalence of hepatitis C virus (HCV) infection in adult patients with a congenital bleeding disorder (CBD) approaches 95% and is a major cause of morbidity and mortality. Histological examination of the liver remains the cornerstone of management decisions in patients without a CBD. The reluctance to perform liver biopsies in patients with a CBD has been a major limitation in the management of these patients. We are currently the only haemophilia centre in Australasia performing liver biopsies in patients with a CBD for the purpose of guiding prognostic and therapeutic decisions. We report here the results of our centre's experience with transjugular liver biopsy (TJLB) in patients with a CBD. An adequate specimen for histological assessment was attained from all of the patients. There were no major complications recorded. Patients were hospitalized for < or = 48 h for haemostasis prophylaxis. The diagnostic specimen obtained from patients was integral in guiding their future management. We suggest that with a coordinated multidisciplinary approach, TJLB can be performed in patients with a CBD.
authors.affiliation: Ronald Sawers Haemophilia Centre and Thrombosis Clinic, Victoria, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Dawson
authors.forename: P H
authors.initials: PH
authors.lastname: McCarthy
authors.forename: M E
authors.initials: ME
authors.lastname: Walsh
authors.forename: C A
authors.initials: CA
authors.lastname: McLean
authors.forename: K
authors.initials: K
authors.lastname: Thomson
authors.forename: S
authors.initials: S
authors.lastname: Roberts
authors.forename: A M
authors.initials: AM
authors.lastname: Street
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D001778:Blood Coagulation Disorders / Q000150:complications / Q000151:congenital / Q000473:pathology*; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D007601:Jugular Veins; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis