title: Value of ultrasound-guided percutaneous liver biopsy in children following liver transplantation.
abstract: OBJECTIVE
  Pediatric liver transplant recipients often need to undergo liver biopsies for the detection and specification of complications such as acute or chronic graft rejection, infection, or drug toxicity. Complications resulting from liver biopsy are rare. The aim of our single-center retrospective study was to report on liver biopsy-related complications and, moreover, to assess the significance of histological findings in correlation with the suspected diagnosis.
  
  
  METHODS
  Overall, 120 liver biopsies from 67 children were performed and analyzed. All of the biopsies were performed with ultrasound guidance using midazolam and ketamine.
  
  
  RESULTS
  The overall incidence of complications was 5.0%, but most of these complications were mild. In 2 cases, however, the complications were severe and required surgical intervention in addition to further medical treatment.In about 92% of the cases, liver histology confirmed the previously suspected diagnosis based on clinical and clinical laboratory indications.
  
  
  CONCLUSIONS
  We concluded that postliver transplantation liver biopsy in children seldom provides unexpected results and, even using ultrasound guidance, has led, albeit rarely, to serious complications. We therefore now accept potential delay in treatment and reserve liver biopsy for patients who fail to respond to therapy based on clinical judgment.
authors.affiliation: Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Marijke
authors.initials: M
authors.lastname: Sornsakrin
authors.forename: Knut
authors.initials: K
authors.lastname: Helmke
authors.forename: Andrea
authors.initials: A
authors.lastname: Briem-Richter
authors.forename: Rainer
authors.initials: R
authors.lastname: Ganschow
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007649:Ketamine; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008107:Liver Diseases / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008874:Midazolam; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D007649:Ketamine; D008874:Midazolam