Utility of liver biopsy in bone marrow transplant patients

Prabhleen Chahal, Cynthia Levy, Mark R. Litzow, Keith D. Lindor

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background and Aim: Hepatic dysfunction is a common cause of morbidity and mortality in bone marrow transplant recipients. During the complex clinical management of these patients, liver biopsies may be obtained during evaluation of abnormal liver tests. The purpose of our study was to assess the safety and use of liver biopsy in this patient population. Methods: In total, 1700 bone marrow transplants were performed at our institution from June 1982 to December 2002. Data from patients who underwent liver biopsy after their transplant were reviewed once they were identified through a computerized medical index system. Impact of the histological diagnosis on subsequent patient management was obtained from clinical records. The histological diagnosis made by dedicated hepatopathologists was used as the 'gold standard' to assess the reliability of clinical diagnosis. Results: Sixty-one patients, comprising 39 males and 22 females, had a liver biopsy performed (27 transjugular, 29 percutaneous, four laparoscopic, one not specified). As a result of liver biopsy, management was changed in 37% of patients and included addition of medical therapy in 11 and cessation of therapy in five patients. Complications from the liver biopsy were observed in 15 (25%) patients and involved 10 cases of pain or bleeding at the biopsy site, four subcapsular hemorrhages, and one arrhythmia leading to death. Conclusion: Liver biopsy, although infrequently obtained during the assessment of hepatic dysfunction in the bone marrow transplant population, can serve as an important diagnostic tool with a significant impact on the clinical management of these patients. Although we observed a higher complication rate, the majority of them were minor.

Original languageEnglish
Pages (from-to)222-225
Number of pages4
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume23
Issue number2
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Fingerprint

Bone Marrow
Transplants
Biopsy
Liver
Hemorrhage
Population
Cardiac Arrhythmias
Morbidity
Safety
Pain
Mortality
Therapeutics

Keywords

  • Bone marrow transplant
  • Hepatic dysfunction
  • Liver biopsy
  • Percutaneous liver biopsy
  • Transjugular liver biopsy

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Utility of liver biopsy in bone marrow transplant patients. / Chahal, Prabhleen; Levy, Cynthia; Litzow, Mark R.; Lindor, Keith D.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 23, No. 2, 01.01.2008, p. 222-225.

Research output: Contribution to journalArticle

Chahal, Prabhleen ; Levy, Cynthia ; Litzow, Mark R. ; Lindor, Keith D. / Utility of liver biopsy in bone marrow transplant patients. In: Journal of Gastroenterology and Hepatology (Australia). 2008 ; Vol. 23, No. 2. pp. 222-225.
@article{2c7a0537f3ff4017b12c65747186e1ef,
title = "Utility of liver biopsy in bone marrow transplant patients",
abstract = "Background and Aim: Hepatic dysfunction is a common cause of morbidity and mortality in bone marrow transplant recipients. During the complex clinical management of these patients, liver biopsies may be obtained during evaluation of abnormal liver tests. The purpose of our study was to assess the safety and use of liver biopsy in this patient population. Methods: In total, 1700 bone marrow transplants were performed at our institution from June 1982 to December 2002. Data from patients who underwent liver biopsy after their transplant were reviewed once they were identified through a computerized medical index system. Impact of the histological diagnosis on subsequent patient management was obtained from clinical records. The histological diagnosis made by dedicated hepatopathologists was used as the 'gold standard' to assess the reliability of clinical diagnosis. Results: Sixty-one patients, comprising 39 males and 22 females, had a liver biopsy performed (27 transjugular, 29 percutaneous, four laparoscopic, one not specified). As a result of liver biopsy, management was changed in 37{\%} of patients and included addition of medical therapy in 11 and cessation of therapy in five patients. Complications from the liver biopsy were observed in 15 (25{\%}) patients and involved 10 cases of pain or bleeding at the biopsy site, four subcapsular hemorrhages, and one arrhythmia leading to death. Conclusion: Liver biopsy, although infrequently obtained during the assessment of hepatic dysfunction in the bone marrow transplant population, can serve as an important diagnostic tool with a significant impact on the clinical management of these patients. Although we observed a higher complication rate, the majority of them were minor.",
keywords = "Bone marrow transplant, Hepatic dysfunction, Liver biopsy, Percutaneous liver biopsy, Transjugular liver biopsy",
author = "Prabhleen Chahal and Cynthia Levy and Litzow, {Mark R.} and Lindor, {Keith D.}",
year = "2008",
month = "1",
day = "1",
doi = "10.1111/j.1440-1746.2006.04742.x",
language = "English",
volume = "23",
pages = "222--225",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Utility of liver biopsy in bone marrow transplant patients

AU - Chahal, Prabhleen

AU - Levy, Cynthia

AU - Litzow, Mark R.

AU - Lindor, Keith D.

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Background and Aim: Hepatic dysfunction is a common cause of morbidity and mortality in bone marrow transplant recipients. During the complex clinical management of these patients, liver biopsies may be obtained during evaluation of abnormal liver tests. The purpose of our study was to assess the safety and use of liver biopsy in this patient population. Methods: In total, 1700 bone marrow transplants were performed at our institution from June 1982 to December 2002. Data from patients who underwent liver biopsy after their transplant were reviewed once they were identified through a computerized medical index system. Impact of the histological diagnosis on subsequent patient management was obtained from clinical records. The histological diagnosis made by dedicated hepatopathologists was used as the 'gold standard' to assess the reliability of clinical diagnosis. Results: Sixty-one patients, comprising 39 males and 22 females, had a liver biopsy performed (27 transjugular, 29 percutaneous, four laparoscopic, one not specified). As a result of liver biopsy, management was changed in 37% of patients and included addition of medical therapy in 11 and cessation of therapy in five patients. Complications from the liver biopsy were observed in 15 (25%) patients and involved 10 cases of pain or bleeding at the biopsy site, four subcapsular hemorrhages, and one arrhythmia leading to death. Conclusion: Liver biopsy, although infrequently obtained during the assessment of hepatic dysfunction in the bone marrow transplant population, can serve as an important diagnostic tool with a significant impact on the clinical management of these patients. Although we observed a higher complication rate, the majority of them were minor.

AB - Background and Aim: Hepatic dysfunction is a common cause of morbidity and mortality in bone marrow transplant recipients. During the complex clinical management of these patients, liver biopsies may be obtained during evaluation of abnormal liver tests. The purpose of our study was to assess the safety and use of liver biopsy in this patient population. Methods: In total, 1700 bone marrow transplants were performed at our institution from June 1982 to December 2002. Data from patients who underwent liver biopsy after their transplant were reviewed once they were identified through a computerized medical index system. Impact of the histological diagnosis on subsequent patient management was obtained from clinical records. The histological diagnosis made by dedicated hepatopathologists was used as the 'gold standard' to assess the reliability of clinical diagnosis. Results: Sixty-one patients, comprising 39 males and 22 females, had a liver biopsy performed (27 transjugular, 29 percutaneous, four laparoscopic, one not specified). As a result of liver biopsy, management was changed in 37% of patients and included addition of medical therapy in 11 and cessation of therapy in five patients. Complications from the liver biopsy were observed in 15 (25%) patients and involved 10 cases of pain or bleeding at the biopsy site, four subcapsular hemorrhages, and one arrhythmia leading to death. Conclusion: Liver biopsy, although infrequently obtained during the assessment of hepatic dysfunction in the bone marrow transplant population, can serve as an important diagnostic tool with a significant impact on the clinical management of these patients. Although we observed a higher complication rate, the majority of them were minor.

KW - Bone marrow transplant

KW - Hepatic dysfunction

KW - Liver biopsy

KW - Percutaneous liver biopsy

KW - Transjugular liver biopsy

UR - http://www.scopus.com/inward/record.url?scp=39149132440&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39149132440&partnerID=8YFLogxK

U2 - 10.1111/j.1440-1746.2006.04742.x

DO - 10.1111/j.1440-1746.2006.04742.x

M3 - Article

VL - 23

SP - 222

EP - 225

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 2

ER -