Transjugular liver biopsy in liver transplant patients using an 18-gauge automated core biopsy needle

Aim of this retrospective study is to evaluate accuracy and safety of transjugular liver biopsy using an 18-gauge automated core biopsy needle, in patients underwent liver transplantation. 183 consecutively transjugular liver biopsy were performed in 115 liver transplant patients. An 18-gauge automated core needle biopsy was used in all patients. Technical success was achieved in 182 procedures (99.5%). In one patient we were not able to obtain a liver sample. The mean number of passages was 1.43 (range 1-5). Mean number of fragments was 2 (range 1-12). Mean total length of the specimens was 1.7 cm (range 0.5-3.4 cm). The specimen was adequate for diagnosis in 172 (94.5%) cases and suboptimal or inadequate in 10 (4.5%). Suboptimal or inadequate samples were associated with higher number of passages (2.0 vs. 1.4, p<0.012), higher number of fragments (4.3 vs. 1.9, p<0.0001) and decreased total length of the specimens (0.99 vs. 1.73, p<0.03). As only complication one patient (0.5%) had a large perihepatic hematoma requiring blood transfusion. In conclusion using an 18-gauge automated core needle biopsy, in most liver transplant recipients, an accurate diagnosis can be obtained with one or two passages. This is associated with a low risk of complications.