title: Safety and utility of transjugular liver biopsy in hematopoietic stem cell transplant recipients.
abstract: OBJECTIVE
  Hematopoietic stem cell transplant (HSCT) recipients are at high risk in the setting of percutaneous liver biopsy as a result of comorbid coagulopathy and ascites, and are commonly referred to undergo transjugular liver biopsy. The present study was performed to assess the safety and utility of transjugular liver biopsy in HSCT recipients and to analyze the correlation between corrected hepatic sinusoidal pressure gradient (CHSPG) and pathologic diagnoses.
  
  
  METHODS
  Data from reports of transjugular liver biopsy procedures, pathology reports, and laboratory values of 141 consecutive HSCT recipients who underwent transjugular liver biopsy with pressure measurement between January 2005 and August 2011 in a single institution were retrospectively reviewed and analyzed.
  
  
  RESULTS
  A total of 166 biopsy procedures were performed in 141 patients. Technical success rate was 98.8%. Biopsy was diagnostic in 95.7% of patients. There were three major complications (1.8%), including one death. CHSPG in patients with venoocclusive disease (VOD) was significantly higher (P<.001) than in those without VOD (16.2 mm Hg±9.2 vs 5.6 mm Hg±3.7). A CHSPG of 10 mm Hg or higher was 90.8% specific and 77.3% sensitive for VOD.
  
  
  CONCLUSIONS
  The present data show that transjugular liver biopsy is a relatively safe procedure that provides important information for the clinical management of patients with HSCT. Measurement of CHSPG during the procedure can support the diagnosis of VOD.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. kisbela@hotmail.com
authors.forename: Bela
authors.initials: B
authors.lastname: Kis
authors.forename: Vishwan
authors.initials: V
authors.lastname: Pamarthi
authors.forename: Chieh-Min
authors.initials: CM
authors.lastname: Fan
authors.forename: Dmitry
authors.initials: D
authors.lastname: Rabkin
authors.forename: Richard A
authors.initials: RA
authors.lastname: Baum
mesh_terms: D001900:Boston / Q000453:epidemiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007601:Jugular Veins / Q000601:surgery; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome