title: US-guided percutaneous liver biopsy in pediatric liver transplant recipients.
abstract: OBJECTIVE
  The present study assesses the safety of ultrasound (US)-guided percutaneous liver biopsies (PLBs) within pediatric liver allograft recipients, describes the pathological results according to early (≤12 months) and late (>12 months) posttransplantation periods, and analyzes the value of liver function tests (LFTs) and Doppler US variables in determining these results.
  
  
  METHODS
  A total of 219 US-guided PLBs in 85 pediatric patients with liver transplant (mean age 7 ± 5 years, range: 6 months to 18 years) performed between March 2005 and May 2012 were retrospectively evaluated at a single institution. Doppler US and LFT evaluation (including total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, alkaline phosphatase) occurred within 1 day of early (n = 92, 42%) and late term (n = 127, 58%) posttransplantation biopsies.
  
  
  RESULTS
  The rate of major complications (hemorrhage requiring blood transfusion) was 0.91% (n = 2). The early versus late term biopsy results, respectively, included: cholestasis at 36% versus 18% (P = 0.003), minimal changes 16% versus 24% (not significant [NS]), acute rejection 13% versus 5% (P = 0.027), inflammatory diseases 15% versus 15% (NS), indeterminate acute rejection 11% versus 7% (NS), chronic rejection 4% versus 14% (P = 0.017), fibrotic diseases 4% versus 12% (NS), and other 0% versus 5% (NS). Neither LFT nor US variables were correlated with pathological outcomes.
  
  
  CONCLUSIONS
  The rate of complications in pediatric patients after US-guided liver biopsy is low. A range of pathological results exists between early and late posttransplantation liver biopsies. LFT and Doppler US findings are not predictors of pathological results.
authors: *Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA †Diagnostic and Therapeutic Services ‡Department of Information Technology §Transplantation Surgery ||Pediatric Hepatology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IsMeTT), Palermo, Italy.
authors: Soma
authors: S
authors: Mandal
authors: Roberto
authors: R
authors: Miraglia
authors: Luigi
authors: L
authors: Maruzzelli
authors: Rosa
authors: R
authors: Liotta
authors: Fabio
authors: F
authors: Tuzzolino
authors: Marco
authors: M
authors: Spada
authors: Silvia
authors: S
authors: Riva
authors: Angelo
authors: A
authors: Luca
mesh_terms: D000293:Adolescent; D001663:Bilirubin / Q000097:blood; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000453:epidemiology*; D005355:Fibrosis / Q000453:epidemiology; D006084:Graft Rejection / Q000453:epidemiology*; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000453:epidemiology; D008099:Liver / Q000201:enzymology / Q000473:pathology* / Q000601:surgery; D008111:Liver Function Tests / Q000379:methods; D016031:Liver Transplantation; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D066027:Transplant Recipients; D014463:Ultrasonography / Q000379:methods
chemical_list: D001663:Bilirubin