Our Summary

This study looked at the safety and effectiveness of a procedure called transjugular liver biopsy (TJLB) performed by liver specialists. TJLB is an alternative to a standard liver biopsy and is often used in patients who have problems with blood clotting or a build-up of fluid in the abdomen. The researchers looked at the results of 445 TJLB procedures performed on 399 patients over a period of 9 years.

They were able to get a clear diagnosis from 95.1% of the biopsies. This includes all patients with sudden liver failure and 97.1% of patients who had a liver transplant. They found that the pressure in the liver’s veins was negatively correlated with the size of the sample and the number of portal tracts (the liver’s small blood vessels).

Among the patients whose cause of liver disease was unknown, the biopsy helped to identify the cause in 83.4% of cases. Complications occurred in 6.3% of biopsies, but these were mostly minor and there were no deaths caused by the procedure. The presence of fluid in the abdomen or problems with blood clotting did not increase the risk of complications.

The researchers concluded that TJLB is a safe procedure when performed by experienced liver specialists and is effective for diagnosing liver disease and sudden liver failure.

FAQs

  1. What is a Transjugular liver biopsy (TJLB) and when is it used?
  2. What are the risks and complications associated with a TJLB?
  3. How effective is a TJLB in diagnosing the etiology of liver disease?

Doctor’s Tip

A helpful tip a doctor might tell a patient about liver biopsy is to make sure to follow all pre-procedure instructions, such as fasting before the biopsy and any medication adjustments. It is also important to inform the healthcare provider about any allergies or current medications being taken. After the procedure, it is important to rest and follow post-biopsy care instructions to minimize any potential complications.

Suitable For

Patients who are typically recommended for liver biopsy include those with suspected liver disease, abnormal liver function tests, unexplained hepatomegaly, suspected cirrhosis, suspected liver cancer, suspected autoimmune liver disease, suspected metabolic liver disease, and evaluation of liver transplant rejection. Additionally, patients with acute liver failure and those with ascites or coagulopathy may also be recommended for liver biopsy, with transjugular liver biopsy being a safer alternative for those with impaired coagulation and ascites.

Timeline

Before liver biopsy:

  • Patient is referred for liver biopsy by their healthcare provider
  • Patient undergoes pre-procedure evaluation to assess liver function, coagulation status, and presence of ascites
  • Patient may be instructed to avoid certain medications leading up to the procedure
  • Patient may receive sedation or local anesthesia before the procedure
  • Patient may be asked to fast before the procedure

After liver biopsy:

  • Patient is monitored for a period of time following the procedure
  • Patient may experience mild discomfort or pain at the biopsy site
  • Patient may be instructed to avoid strenuous activities for a period of time
  • Patient may need to follow up with their healthcare provider for results and further management based on biopsy findings.

What to Ask Your Doctor

  1. What is the reason for recommending a liver biopsy?
  2. What information can be obtained from the liver biopsy results?
  3. How will the liver biopsy be performed?
  4. What are the potential risks and complications associated with the liver biopsy procedure?
  5. How experienced is the doctor in performing transjugular liver biopsies?
  6. How will the biopsy results be used to guide treatment decisions?
  7. How long will it take to receive the biopsy results?
  8. Are there any specific instructions to follow before or after the liver biopsy procedure?
  9. Are there any alternative diagnostic tests or procedures that can provide similar information?
  10. What is the likelihood of obtaining a conclusive diagnosis from the liver biopsy?

Reference

Authors: Stift J, Semmler G, Walzel C, Mandorfer M, Schwarzer R, Schwabl P, Paternostro R, Scheiner B, Wöran K, Pinter M, Stättermayer AF, Trauner M, Peck-Radosavljevic M, Ferlitsch A, Reiberger T. Journal: Dig Liver Dis. 2019 Aug;51(8):1144-1151. doi: 10.1016/j.dld.2019.01.020. Epub 2019 Feb 12. PMID: 30862438