Transjugular liver biopsy is a safe and effective intervention to guide management for patients with a congenital bleeding disorder infected with hepatitis C.
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.
Dawson
M A
MA
Ronald Sawers Haemophilia Centre and Thrombosis Clinic, Victoria, Australia.
McCarthy
P H
PH
Walsh
M E
ME
McLean
C A
CA
Thomson
K
K
Roberts
S
S
Street
A M
AM
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