Liver biopsy in children: position paper of the ESPGHAN Hepatology Committee.
Liver biopsy (LB) is still the criterion standard procedure for obtaining liver tissue for histopathological examination and a valuable tool in the diagnosis, prognosis, and management of many parenchymal liver diseases. The aim of this position paper is to summarise the present practice of paediatric LB and make recommendations about its performance. Although histological evaluation of the liver is important in assessing prognosis and exploring treatment, noninvasive techniques (ie, imaging, laboratory markers) may replace use of liver histology. The indications for LB are changing as present knowledge of aetiologies, pathomechanism, and therapeutic options in paediatric liver disease is evolving. Adult and paediatric literature was reviewed to assess the existing clinical practice of LB with focus on the technique, indications, risk of complications, and contraindications in paediatrics. This position paper presents types of LB, indications, complications, contraindications, and an essential checklist for paediatric LB.
*First Department of Pediatrics, Semmelweis University, Budapest, Hungary †Paediatric Gastroenterology and Hepatology, Hannover Medical School, Hannover, Germany ‡Kings College London School of Medicine at Kings College Hospital, London, UK §Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey ||Department of Pediatrics, CLINTEC, Karolinska University Hospital, Stockholm, Sweden ¶Paediatric Centre for Hepatology, Gastroenterology and Nutrition, King's College Hospital, London, UK #Pediatric Hepatology Service, Hospital Infantil Universitario "La Paz," Madrid,Spain **Necker-Enfants Malades Hospital, Paris, France ††Pediatric Gastroenterology Unit, Department of Pediatrics, University Hospitals Geneva, Switzerland ‡‡Hepatometabolic Unit, Bambino Gesu Children's Hospital, Rome, Italy §§Department of Gastroenterology, Hepatology and Nutritional Disturbances, Children's Memorial Health Institute, Warsaw, Poland ||||Department of Medicine and Surgery, University of Salerno, Salerno, Italy ¶¶Institute of Liver Studies/King's College Hospital, London, UK.
Antal
A
Dezsőfi
Ulrich
U
Baumann
Anil
A
Dhawan
Ozlem
O
Durmaz
Björn
B
Fischler
Nedim
N
Hadzic
Loreto
L
Hierro
Florence
F
Lacaille
Valérie A
VA
McLin
Valerio
V
Nobili
Piotr
P
Socha
Pietro
P
Vajro
Alexander S
AS
Knisely
D001706:Biopsy / Q000009:adverse effects / Q000592:standards; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D005060:Europe; D019317:Evidence-Based Medicine; D005762:Gastroenterology / Q000379:methods* / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology; D052756:Nutritional Sciences / Q000379:methods* / Q000639:trends; D010372:Pediatrics / Q000379:methods* / Q000639:trends; D057285:Precision Medicine; D011379:Prognosis; D012955:Societies, Medical