Safety, Feasibility, Yield, Diagnostic and Prognostic Implications of Transjugular Liver Biopsy in Children and Adolescents

Objectives: The objectives of the study were to evaluate the indications, feasibility, complications and clinical implications of transjugular liver biopsy (TJLB) in children. Methods: Data of all TJLB performed in children Results: A total of 102 children, including 5 with acute liver failure underwent TJLB with technical success in 101 (99%). A mean of 2.3 +/- 0.9 passes (range: 1-5) was taken for the biopsy. The most common indications for TJLB in our cohort were elevated international normalized ratio >1.5 (66, 64.7%), ascites (46, 45.1%) and thrombocytopenia (platelet count < 60,000/mm(3)) (42, 41.2%). Mean size of the tissue received was 14.5 +/- 5.6 mm with an average of 10.2 +/- 4.7 portal tracts. Only one child developed major (category D) complication (hemobilia) and 12 (11.8%) developed minor complications post-procedure. Etiological diagnosis could be made in a total of 64 (63.9%) children undergoing TJLB, the most common diagnosis being autoimmune hepatitis (n = 31), non-cirrhotic portal fibrosis (n = 16) and drug-induced liver injury (n = 4). Conclusion: TJLB is well tolerated, feasible and helps make a diagnosis in close to 64% children allowing timely medical and/or surgical intervention. It is especially useful for diagnosis of autoimmune liver diseases, drug-induced liver injury and non-cirrhotic portal fibrosis.

Automated summary

The study evaluated the indications, feasibility, complications, and clinical implications of transjugular liver biopsy in children. The results showed that it is well tolerated, feasible, and helpful in making a diagnosis for about 64% of children, allowing timely medical and/or surgical intervention. Autoimmune hepatitis, drug-induced liver injury, and non-cirrhotic portal fibrosis are the most common diagnoses made.