[Liver biopsy in liver patients with coagulopathy].
The risk of severe bleeding after liver biopsy is estimated to be 1:12,000 in patients with near normal coagulation (INR < 1,5 and platelet count > 60 billion /l). Beyond these limits, the risk is higher, but still uncertain. The Danish guidelines require INR > 1.5, platelet count < 40 billion /l and normal APTT. In some instances the risk of not knowing the histology is so high that a biopsy is considered even with a more disturbed coagulation. Vitamin K, freshly frozen plasma and recombinant activated factor VII may reduce the risk of bleeding in specific situations, but no firm recommendations can be given.
Ott
Peter
P
Medicinsk Hepato-gastroenterologisk Afdeling V, Arhus Universitetshospital, Arhus Sygehus, DK-8000 Arhus C. peott@as.aaa.dk
Grønbaek
Henning
H
Clemmesen
Jens Otto
JO
Clausen
Mette Rye
MR
Wettergren
André
A
Havelund
Troels
T
Feldager
Erik
E
Bendtsen
Flemming
F
Hansen
Bent Adel
BA
Tage-Jensen
Ulrik
U
Larsen
Lars Peter
LP
Vilstrup
Hendrik
H
D001706:Biopsy / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000473:pathology; D000075202:Contraindications; D006470:Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D019934:International Normalized Ratio; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000150:complications* / Q000473:pathology; D010976:Platelet Count; D012307:Risk Factors