Our Summary

This paper discusses a study on a technique called plugged percutaneous biopsy (PPB), which is used to take samples of the liver in a way that minimizes bleeding. PPB is especially useful when there’s a risk of bleeding after the biopsy. In this study, the researchers used PPB to examine liver grafts in patients who had received liver transplants from living donors, as they suspected the grafts might be getting rejected.

The study looked back at data from 51 patients who had this procedure done between 2007 and 2013. In total, 73 biopsies were carried out. For each biopsy, they either used a gelatin sponge or a substance called N-butyl cyanoacrylate (NBCA) to stop any bleeding along the biopsy path.

The researchers found that they were successful in getting a sample every time (100% success rate). In almost all cases (95.9%), the samples were good enough to make a diagnosis. On average, they could see about 9.8 full portal tracts (parts of the liver) in each sample. There was only one small complication where a patient had a short-lived fever after the procedure.

In conclusion, PPB is an effective and safe way to take liver samples in patients who have received liver transplants from living donors. It helps doctors make a diagnosis and has a very low risk of complications.

FAQs

  1. What is plugged percutaneous biopsy (PPB) of the liver?
  2. How effective and safe is PPB of the liver in patients suspected of having graft rejection after living-donor liver transplantation (LDLT)?
  3. What materials are used to embolize the needle tract during a PPB procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about liver biopsy is to follow all pre-procedure instructions provided, such as fasting before the biopsy and avoiding certain medications that may increase the risk of bleeding. Additionally, it is important to inform the doctor of any allergies or medical conditions before the procedure. After the biopsy, it is important to follow any post-procedure instructions provided by the doctor, including avoiding strenuous activity and monitoring for any signs of infection or bleeding.

Suitable For

Patients who are typically recommended liver biopsy include those with suspected liver disease, such as hepatitis, cirrhosis, or liver cancer. Patients who have abnormal liver function tests, unexplained jaundice, or abnormal imaging studies of the liver may also be candidates for a liver biopsy. Additionally, patients who have undergone liver transplantation, particularly living-donor liver transplantation, may undergo liver biopsy to evaluate for graft rejection.

Timeline

Before liver biopsy:

  • Patient undergoes initial evaluation and consultation with a healthcare provider
  • Patient may undergo imaging tests such as ultrasound or CT scan to identify the location of the liver lesion
  • Patient may need to fast for a certain period of time before the procedure
  • Patient may receive sedation or anesthesia before the biopsy
  • Patient signs a consent form

After liver biopsy:

  • Patient is monitored for a few hours after the procedure for any signs of complications such as bleeding or infection
  • Patient may experience some pain or discomfort at the biopsy site
  • Patient is advised to avoid strenuous activities for a few days after the biopsy
  • Results of the biopsy are typically available within a few days to a week
  • Patient follows up with their healthcare provider to discuss the biopsy results and determine further treatment if necessary.

What to Ask Your Doctor

  1. What is the purpose of the liver biopsy?
  2. What are the potential risks and complications associated with the biopsy procedure?
  3. How will the biopsy results be used to guide my treatment plan?
  4. Will I need to make any special preparations before the biopsy?
  5. How long will it take to recover from the biopsy procedure?
  6. Are there any specific instructions I should follow after the biopsy?
  7. How soon will I receive the results of the biopsy?
  8. How will the biopsy results impact my overall liver health and management?
  9. Are there any alternative diagnostic tests or procedures that could be considered instead of a liver biopsy?
  10. What experience do you have in performing liver biopsies, particularly in patients with my specific condition or history?

Reference

Authors: Kim SJ, Won JH, Kim YB, Wang HJ, Kim BW, Kim H, Kim J. Journal: Acta Radiol. 2017 Jul;58(7):771-777. doi: 10.1177/0284185116673121. Epub 2016 Oct 17. PMID: 27754919