title: Transfemoral liver biopsy using a Quick-Core biopsy needle system in living donor liver transplantation recipients.
abstract: The purpose of this study was to evaluate the efficacy and safety of transfemoral liver biopsy with a Quick-Core biopsy needle in select living donor liver transplantation (LDLT) recipients. Eight LDLT recipients underwent 9 transfemoral liver biopsy sessions. Six patients had undergone modified right lobe (mRL) LDLT, and 2 patients had undergone dual-left lobe LDLT. The indications for transfemoral liver biopsy were a hepatic vein (HV) at an acute angle to the inferior vena cava (IVC) on the coronal plane and a thin (<10-mm) liver parenchyma surrounding the HV to be biopsied on enhanced computed tomography. Under fluoroscopic guidance, the right inferior HV in the mRL or the left HV in the right-sided left lobe with a cranial orientation was negotiated with a 5-Fr catheter via the common femoral vein. Then, a stiffening cannula was introduced into the HV over a stiff guide wire. Needle passage was then performed with an 18- or 19-gauge Quick-Core biopsy needle. Technical success was achieved in all sessions without major complications. The median number of needle passages was 4 (range = 2-6). The median total length of obtained liver specimens in each session was 44 mm (range = 24-75 mm). The median number of portal tracts was 18 (range = 10-29), and the obtained liver specimens were adequate for histological diagnosis in all sessions. In conclusion, transfemoral liver biopsy with a Quick-Core biopsy needle is an effective and safe alternative for obtaining a liver specimen when standard transjugular liver biopsy is not feasible because of an unfavorable HV angle with respect to the IVC and/or a thin liver parenchyma surrounding the HV.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea; Department of Interventional Radiology, First Hospital of Lanzhou University, Lanzhou, People's Republic of China.
authors.forename: Fen Qiang
authors.initials: FQ
authors.lastname: Li
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Kyu-Bo
authors.initials: KB
authors.lastname: Sung
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Gwon
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D005268:Femoral Vein; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008099:Liver / Q000473:pathology; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D066027:Transplant Recipients; D055815:Young Adult