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Transjugular liver biopsy in BMT

E Carreras¹, A Grañena, M Navasa

¹Postgraduate School of Hematology Farreras Valenti, Hospital Clínic, Barcelona, Spain.

Bone Marrow Transplantation

|January 1, 1993

Summary

Transjugular liver biopsy safely evaluates liver issues after bone marrow transplants (BMT). This procedure helps diagnose veno-occlusive disease (VOD) and graft-versus-host disease (GVHD), guiding treatment decisions for BMT patients.

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Area of Science:

Hepatology
Transplantation Medicine
Diagnostic Procedures

Background:

Liver disturbances are a significant complication following bone marrow transplantation (BMT).
Accurate diagnosis of hepatic complications is crucial for patient management and outcomes.

Purpose of the Study:

To evaluate the effectiveness and safety of transjugular liver biopsy in assessing liver disturbances post-BMT.
To determine the diagnostic yield of hepatic venous pressure gradient (HVPG) measurement and liver biopsy in identifying specific complications like VOD and GVHD.

Main Methods:

Hepatic venous pressure gradient (HVPG) measurement and transjugular liver biopsy were performed in 76 patients undergoing BMT.
Catheterization success rate was 93%, with 82 total procedures.
Complications were monitored, and diagnostic modifications were recorded.

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Main Results:

The procedure modified diagnosis in 45% and both diagnosis and treatment in 30% of patients.
Veno-occlusive disease (VOD) was confirmed in 58% of suspected cases, and acute GVHD of the liver in 43% of suspected cases.
HVPG was significantly higher in VOD (14/17 patients > 9 mmHg) compared to liver GVHD (0/17 patients > 9 mmHg).

Conclusions:

Transjugular liver biopsy is a safe and effective method for evaluating BMT-related liver dysfunction.
HVPG measurement combined with biopsy aids in differentiating VOD from liver GVHD.
This diagnostic approach significantly impacts patient diagnosis and treatment strategies.